Swine Flu & Other Pandemics

WHO Warns of Severe Form of Swine Flu

August 28, 2009

Reuters – Doctors are reporting a severe form of swine flu that goes straight to the lungs, causing severe illness in otherwise healthy young people and requiring expensive hospital treatment, the World Health Organization said on Friday.

Some countries are reporting that as many as 15 percent of patients infected with the new H1N1 pandemic virus need hospital care, further straining already overburdened healthcare systems, WHO said in an update on the pandemic.

“During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services,” it said.

“Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.”

Earlier, WHO reported that H1N1 had reached epidemic levels in Japan, signaling an early start to what may be a long influenza season this year, and that it was also worsening in tropical regions.

“Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections,” WHO said.

“In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.”

Report: Swine Flu Could Cause Up to 90,000 U.S. Deaths

August 24, 2009

CNN Story Highlights:

• Panel: Up to 50 percent of U.S. population could be infected this fall, winter
• H1N1, plus seasonal flu, could place "enormous stress" on hospitals
• Vaccine expected in mid-October, but too late to help many, panel says
• Panel urges availability of some doses by mid-September

The H1N1 flu virus could cause up to 90,000 U.S. deaths, mainly among children and young adults, if it resurges this fall as expected, according to a report released Monday by a presidential advisory panel.

The H1N1 virus, commonly known as swine flu virus, could infect between 30 percent and 50 percent of the American population during the fall and winter and lead to as many as 1.8 million U.S. hospital admissions, the President's Council of Advisors on Science and Technology reported.

The report says 30,000 to 90,000 deaths are projected as part of a "plausible scenario" involving large outbreaks at schools, inadequate antiviral supplies and the virus peaking before vaccinations have time to be effective.

Up to 40,000 U.S. deaths are linked to seasonal flu each year, with most of the fatalities occurring among people over 65. With seasonal flu and H1N1, this fall is expected to bring more influenza deaths and place "enormous stress" on intensive care units nationwide, which normally operate near capacity, the report says.

An H1N1 resurgence may happen as early as September, at the beginning of the school year, and infections may peak in mid-October, according to the report. However, the H1N1 vaccine isn't expected to be available until mid-October, and even then it will take several weeks for vaccinated individuals to develop immunity, the report says.

The potential "mismatch in timing" could significantly diminish the usefulness of the H1N1 vaccine, the report says.

"Even with the best efforts, this will cause some illness, some severe illness and unfortunately, some deaths," Thomas Frieden, director of the Centers for Disease Control and Prevention, said Monday.

"But a lot so far has gone remarkably right," Frieden said. "There's a vaccine well on its way to being distributed, diagnostic tests available in well over 100 laboratories, treatments pre-positioned around the country ... and guidance issued for health care providers, schools, businesses and other communities."

Among the report's recommendations are for government agencies to:

• Prepare several "planning scenarios" to determine demand for supplies and care.
• Set up surveillance systems to track information about influenza-like illnesses.
• Develop plans to protect the public's most vulnerable groups, such as pregnant women and those with pre-existing medical conditions.
• Speed up the production of the H1N1 vaccine and have an initial batch -- enough to vaccinate up to 40 million people, especially those who are at risk of serious disease -- by mid-September.

Health and Human Services Secretary Kathleen Sebelius said the government's preparation and guidance for the public was based on the need to strike a balance "on a continuum of being paralyzed with fear versus complacency."

So far, clinical trials for the H1N1 vaccine have not indicated adverse side effects beyond what are experienced with the seasonal flu vaccine, Sebelius said.

However, there would be no formal decision to launch a vaccination campaign until those trials were complete, she said. That decision would be hers, she said, and she emphasized that any vaccination program would be strictly voluntary.

Pregnant women, health care workers and parents or guardians of infants under 6 months of age are among the most vulnerable segments of the population, Sebelius has said. Adults under the age of 65 with an underlying health condition -- such as asthma -- are also considered to be more at risk from the H1N1 virus.

H1N1 preparation guidelines for the nation's businesses and school systems were released three weeks ago. The plans are available at the Web site www.flu.gov.

The H1N1 vaccine would require two shots, the second three weeks after the first. Immunity to the virus would not kick in until two weeks after the second shot.

The World Health Organization declared the H1N1 virus a global pandemic on June 11. More than 1,490 people around the world have died from the virus since it emerged this spring, a WHO official said last week.

Experts Warn Tamiflu Can Make Swine Flu Virus Resistant to Treatment

August 24, 2009

LA Times - Indiscriminate use of antiviral medications to prevent and treat influenza could ease the way for drug-resistant strains of the novel H1N1 virus, or swine flu, to emerge, public health officials warn — making the fight against a pandemic that much harder.

Already, a handful of cases of Tamiflu-resistant H1N1 have been reported this summer, and there is no shortage of examples of misuse of the antiviral medications, experts say.

People often fail to complete a full course of the drug, according to a recent British report — a scenario also likely to be occurring in the U.S. and one that encourages resistance. Stockpiling is rife, and some U.S. summer camps have given Tamiflu prophylactically to healthy kids and staff, and have even told campers to bring the drug to camp. Experts anticipate more problems in the fall as children return to school and normal flu season draws nearer.

“Influenza viruses mutate frequently and any viral resistance could be acquired easily,” said Dr. Anne Schuchat, director of the National Center on Immunization and Respiratory Disease at the Centers for Disease Control and Prevention in Atlanta. “It won’t surprise us if we see resistance emerge as a bigger problem in the fall or in the years ahead.”

Prescribed in pill form, Tamiflu (oseltamivir) works by preventing the flu virus from leaving infected cells and spreading to new ones. Because a vaccine against pandemic H1N1 influenza will not be widely available for several months, Tamiflu and to a lesser extent Relenza (zanamivir), an antiviral that acts similarly, are key medical tools for fighting the pandemic in the meantime.

On Friday, however, the World Health Organization advised doctors that even those who are sickened with swine flu do not need to be given Tamiflu or Relenza if they are only mildly or moderately sick and are not in a high-risk group (such as children under 5, pregnant women and those with an underlying health condition).

Both drugs can help prevent illness in people exposed to the virus and reduce illness severity in people already sickened with it. On Aug. 14, after U.S. national soccer team forward Landon Donovan was diagnosed with H1N1 flu, players, coaches and support staff of the U.S. and Galaxy teams were advised to take Tamiflu as a preventive measure.

Tamiflu was chosen a few years ago for stockpiling by the federal government to deal with future pandemics...

Anxiety over indiscriminate use is growing, and taking the medications cavalierly is not without consequence. British health authorities reported Aug. 2 that cases of side effects from Tamiflu had doubled in the prior week, coinciding with the July 24 launch of a program in England to provide antivirals to anyone with H1N1 influenza who requests it over the phone or online.

In the first three days of the program, 150,000 packets of Tamiflu were dispensed and 293 cases of side effects were reported. Tamiflu can cause vomiting, diarrhea and mild neuropsychiatric effects.

Some U.S. health authorities have also expressed concern over misuse of the medications... americans are known to hoard antivirals: A 2006 study showed that heightened anxiety over a possible avian flu pandemic caused Tamiflu prescriptions to soar 300% in 2004 and 2005.

Just as with antibiotics, of central importance to antivirals’ success is taking them properly, including completing the recommended course.

However, a study published in late July found poor adherence among children in London who took Tamiflu for prevention of pandemic H1N1 in the spring. Less than half of the grade-school-age children and only 76% of the 13- and 14-year-old students completed a full course of medication. More than half of the children reported side effects, such as nausea, stomach cramps and trouble sleeping. Almost one in five reported a neuropsychiatric side effect, such as poor concentration, confusion or bad dreams, even though the U.S. Food and Drug Administration says neuropsychiatric side effects are rare.
Moreover, a study published this week found that Tamiflu and Relenza are unlikely to prevent complications, such as asthma flare-ups or ear infections, in children who have seasonal influenza. But they do increase the risk of vomiting.

The authors of the study, published in the British Medical Journal, said they don’t know if their findings can be generalized to the pandemic flu strain...

Health Experts Have Contradicted the Government’s Policy Over Tamiflu

August 21, 2009

Evening Standard - The Government is refusing to change its swine flu policy after experts said healthy people should not be given Tamiflu.

The World Health Organisation advice directly contradicts British policy on the issue.

The WHO said most patients were experiencing typical flu symptoms and would get better within a week, and Tamiflu should not be given to healthy people.

A spokesman for the Department of Health said: “We believe a safety-first approach of offering antivirals, when required, to everyone remains a sensible and responsible way forward. “However, we will keep this policy under review as we learn more about the virus and its effects.” He added that the WHO recommendations are “in line” with UK policy on antivirals.

The NHS has given out hundreds of thousands of doses of the antiviral since the start of the pandemic, and the national swine flu hotline was set up to make it easier for people to bypass their GP and get the drug.

But Chief Medical Officer Sir Liam Donaldson admitted that less than 10 per cent of those who have been prescribed Tamiflu actually have swine flu. Figures show that staff on the hotline authorised 45,986 courses of antivirals in the past week.

Many more people have collected antivirals after seeing their doctor.

During the early stages of the pandemic, Tamiflu was given to people who had been in contact with swine flu victims, even if they were not showing symptoms.

Today’s WHO advice comes after a government watchdog raised fears that Tamiflu can put some people at greater risk of suffering a stroke. The Medicines and Healthcare products Regulatory Agency alerted GPs to the potential problem.

Researchers at Oxford University have also warned that children with mild symptoms should not be given the drug because of side effects. There have also been claims that mass use of Tamiflu will encourage the virus to become resistant to the antiviral and can cause nightmares in children.

Today’s advice, published on the WHO website, said Tamiflu (also called oseltamivir) and another antiviral Relenza (also called zanamivir) should not be given to healthy people.

However, the drugs should be given quickly to patients in a serious condition or who appear to be deteriorating. Those in at-risk groups — such as people with an underlying medical condition such as diabetes — should also receive the drugs promptly.

A statement said the new guidelines “represent the consensus reached by an international panel of experts who reviewed all available studies on the safety and effectiveness of these drugs”.

It went on: “Healthy patients with uncomplicated illness need not be treated with antivirals.”
TV presenter Andrew Castle has publicly criticised Tamiflu after revealing that his daughter Georgina nearly died after taking it. Mr Castle said the 16-year-old suffered an asthma attack and was hospitalised after being given a double dose of the antiviral in May, when there was a swine flu outbreak at her school, Alleyn’s in Dulwich. Tests later revealed that she did not have the virus.

Brit Media Reports On H1N1 Mass Graves

August 19, 2009

The Sun - Plans for mass graves have been drawn up to cope with a second wave of swine flu this Autumn. The chilling proposals are spelled out in a Home Office document discussed at a meeting of Whitehall officials and council leaders last month. It warns emergency plans may be needed in areas where there are not enough graves to cope.

The 59-page document talks about using "a grave that is for a number of unrelated persons, excavated mechanically in advance and designed for efficient preparation and use."

It said this approach would create a "burial site for multiple graves and consecutive burials." But it stressed there must still be "marking of the position of individual burials."

The document is called A Framework for Planners Preparing to Manage Deaths.

The meeting heard the number of burials could more than double within a few weeks of a full-blown pandemic. It heard a presentation on the Home Office guidance from John Barrelled, a senior official from Westminster City Council. The document warned some cemeteries "may experience shortage of grave space, in particular in inner city areas."

Freight containers and "inflatable" storage units may be needed to provide extra mortuary space. But it stressed "refrigerated vehicles and trailers should not be used."

Cemeteries and crematoriums may need to work seven days a week and hire extra staff to cope. It also warned there may be a need for more "basic and shorter services at the chapel" or for "memorial services" to be held at a person's home instead. It may no longer be possible to bury some people in family plots. New laws could be passed to allow "streamlined" cremations.

Whitehall officials are speaking to coffin makers to see if they can meet demand. Retired docs could be drafted in to issue death certificates so GPs can focus on patients. It may also become impossible to fly home the bodies of Britons who die abroad. Presently 30 percent of people are buried.

New cases of swine flu have fallen sharply from a peak of over 110,000 a week in late July. But experts predict a second wave this autumn.

New York Funeral Directors Prepare for 85,000 Swine Flu Deaths

August 13, 2009

Astoria Times - City officials are bracing for a surge of swine flu cases this fall and funeral home directors need to be prepared to accommodate a possible related 50,000 to 85,000 deaths, the director of the Metropolitan Funeral Directors Association told a gathering of funeral home representatives in Forest Hills last week.

“As funeral directors, we really need to know what we’re about to face,” Martin Kasdan said. “When swine flu comes back, it could possibly be devastating.”

About 15 officials from area funeral homes attended the meeting sponsored by the MetFDA at Schwartz Brothers in Forest Hills Aug. 6. The MetFDA is holding four meetings in the city and one in Westchester this month to better prepare funeral homes for a possible increase in deaths as well as a rise in the number of sick and absent employees.

MetFDA officials said they were also relaying information from the meetings to city agencies, including the city Health Department and the medical examiner’s office, with which they have been working in preparation for a potential second wave of swine flu.

Swine flu, otherwise known as H1N1, first hit the city in May in a group of St. Francis Preparatory students in Fresh Meadows. The outbreak occurred after the students had arrived home from a trip to Mexico, where the World Health Organization said the global pandemic originated.

As of July, more than 900 New Yorkers had been hospitalized with H1N1 and 47 had died, including two Queens residents, according to city statistics.

Flushing resident Mitchell Wiener, an assistant principal at IS 238 in Hollis, became the city’s first swine flu casualty May 17. A second unnamed woman from Queens died from swine flu May 24, according to the city.

City residents continue to come down with H1N1, but the numbers have continually decreased since the spike of cases in May, health officials said.

“The Health Department monitors influenza-like illnesses every day in New York City,” said city Health Commissioner Thomas Farley. “While every hospitalization is concerning and every death is a tragedy, our surveillance data indicate that the number of people newly infected is declining.”

The Centers for Disease Control has predicted a 2.1 percent to 3.3 percent death rate among those who come down with swine flu this fall, which translates into an additional 52,000 to 86,000 deaths in the city over a three-month period, Kasdan said.

“It’s mind-boggling,” Kasdan said of the possible death rate. “Is the CDC right? Who knows — hopefully not. But you need to be prepared.”

The potential upswing in fatalities poses a wide array of questions for city officials and funeral directors, such as where to store bodies, how to hold funerals in a climate where swine flu is passed easily from person to person and how many extra supplies will be needed.

“You may have to wait for funerals because the family is sick or until the cemetery says they’re able to do the burial,” Kasdan said. “You might have to store bodies longer.”

Kasdan said the city medical examiner is already looking into possibly using vacant city buildings to store bodies, and the city has contracted for a unit to be built in Germany that will handle hundreds of bodies.

They're Getting Ready for Something Big This Fall

July 29, 2009

Dissecting The New Age - Now more than ever this is looking to be the case.

It's obvious they're getting the public ready for mandatory swine flu vaccinations. They're not publicly calling for mandatory vaccinations yet, but clearly it's heading in that direction. Anyone who has seen the World Health Organization (WHO) memos knows what their plans are. The only way for them to pull this off is to declare emergency powers under martial law. I believe this will happen in the fall.

The WHO said a week ago they were looking for mutations in the virus. Now it's being said that mutations are likely and that the flu will intensify this fall. This is predictive programming.

Now, just today, it was announced that the US military wants to establish regional teams of military personnel to assist civilian authorities in the event of an outbreak. This is martial law.

Military Planning for Possible H1N1 Outbreak

CNN - The U.S. military wants to establish regional teams of military personnel to assist civilian authorities in the event of a significant outbreak of the H1N1 virus this fall, according to Defense Department officials.

The proposal is awaiting final approval from Defense Secretary Robert Gates.

The officials would not be identified because the proposal from U.S. Northern Command's Gen. Victor Renuart has not been approved by the secretary.

The plan calls for military task forces to work in conjunction with the Federal Emergency Management Agency. There is no final decision on how the military effort would be manned, but one source said it would likely include personnel from all branches of the military.

It has yet to be determined how many troops would be needed and whether they would come from the active duty or the National Guard and Reserve forces.

Civilian authorities would lead any relief efforts in the event of a major outbreak, the official said. The military, as they would for a natural disaster or other significant emergency situation, could provide support and fulfill any tasks that civilian authorities could not, such as air transport or testing of large numbers of viral samples from infected patients.

As a first step, Gates is being asked to sign a so-called "execution order" that would authorize the military to begin to conduct the detailed planning to execute the proposed plan.

Orders to deploy actual forces would be reviewed later, depending on how much of a health threat the flu poses this fall, the officials said.

Ethicist Worried Swine Flu Vaccine May Be More Dangerous Than the Virus Itself

August 16, 2009

CTV - The race is on to create a vaccine for swine flu, as many infectious disease experts warn that the northern hemisphere could face a “second wave” of H1N1. But some worry the fast-tracked vaccine may be more dangerous than the virus itself.
 
Across Europe, Asia and the U.S., vaccine manufacturers have begun testing the first batches of the vaccines, with volunteers rolling up their sleeves to try the new formulations for safety and effectiveness. They will be testing different dosages, looking to see if any trigger immune reactions or other possible side effects.

But in his office in Winnipeg, University of Manitoba medical ethicist Dr. Arthur Schafer is worried.

“We're rushing the vaccines, there isn’t time for them to be properly tested for effectiveness; there won’t be time for them to be properly tested for safety,” he tells CTV News.

The vaccine is being touted as our best weapon against the virus, and hailed as a sort of “magic bullet.” But Schafer notes that the first scientific data will only provide information on the correct dosage and immediate reactions from the shot. Long-term safety data won’t be available when vaccination programs begin in the fall.

“So the claim that we know it to be safe and effective just isn’t levelling with the Canadian public. No one knows that,” says Schafer.

Many remember the ill-advised mass vaccination program in the U.S. in 1976, when millions of Americans and some Canadians got a vaccine for a virus that quickly fizzled out.

About 4,000 people became ill after getting immunized, including about 500 who came down with Guillain-Barré syndrome, a paralyzing though generally temporary neuromuscular disorder. When anger over the vaccine program reached a crescendo, the program was quickly withdrawn and the U.S. government was left with a $3-billion lawsuit.

The World Health Organization has acknowledged safety issues “will inevitably arise during a pandemic when vaccine is administered on a massive scale. For example, adverse events too rare to show up even in a large clinical trial may become apparent when very large numbers of people receive a pandemic vaccine.”

Still, Schafer says he’s not comfortable with the plan to encourage every Canadian to get the vaccine. He recently let his feelings be known in an interview with the Winnipeg Free Press and says his comments seemed to hit a nerve.

“I’ve had a lot of feedback from scientists around the country who have emailed or phoned to say they are relieved someone is flagging these concerns,” he says.

Shafer says the evidence from the southern hemisphere suggests swine flu is no more lethal than the seasonal flu. So he wonders why a mass vaccination program is being considered.

“There are serious public health issues and issues of ethics as to whether we should be distributing (vaccines) massively to healthy people, including children and pregnant women, when there are really big question marks about their effectiveness and their safety.”

But Toronto vaccine specialist Dr. Allison McGeer says speeding the vaccine through production and testing is necessary.

She says as the safety data comes in, in the coming weeks, and a clearer picture of swine flu’s effects in the southern hemisphere emerges, decisions will be made about who needs it.

“The order is insurance,” she said, referring to the vaccine.

McGeer agrees that open public discussion is needed. She points out that there are risks to any influenza, including swine flu. The vaccine is designed to protect those at risk.

“The recommendation is based on a very careful assessment of what the risks of influenza are, and what the benefits (and risks) of the vaccine are.”

Neurologists Warn That Swine Flu Vaccine Linked to Deadly Nerve Disease

August 15, 2009

Daily Mail (London) - A warning that the new swine flu jab is linked to a deadly nerve disease has been sent by the Government to senior neurologists in a confidential letter.

The letter from the Health Protection Agency, the official body that oversees public health, has been leaked to The Mail on Sunday, leading to demands to know why the information has not been given to the public before the vaccination of millions of people, including children, begins.

It tells the neurologists that they must be alert for an increase in a brain disorder called Guillain-Barre Syndrome (GBS), which could be triggered by the vaccine. GBS attacks the lining of the nerves, causing paralysis and inability to breathe, and can be fatal.

The letter, sent to about 600 neurologists on July 29, is the first sign that there is concern at the highest levels that the vaccine itself could cause serious complications. It refers to the use of a similar swine flu vaccine in the United States in 1976 when:

• More people died from the vaccination than from swine flu.
• 500 cases of GBS were detected.
• The vaccine may have increased the risk of contracting GBS by eight times.
• The vaccine was withdrawn after just ten weeks when the link with GBS became clear.
• The US Government was forced to pay out millions of dollars to those affected.

Concerns have already been raised that the new vaccine has not been sufficiently tested and that the effects, especially on children, are unknown.

It is being developed by pharmaceutical companies and will be given to about 13 million people during the first wave of immunisation, expected to start in October. Top priority will be given to everyone aged six months to 65 with an underlying health problem, pregnant women and health professionals. The British Neurological Surveillance Unit (BNSU), part of the British Association of Neurologists, has been asked to monitor closely any cases of GBS as the vaccine is rolled out.

One senior neurologist said last night: ‘I would not have the swine flu jab because of the GBS risk.’

There are concerns that there could be a repeat of what became known as the ‘1976 debacle’ in the US, where a swine flu vaccine killed 25 people – more than the virus itself.

A mass vaccination was given the go-ahead by President Gerald Ford because scientists believed that the swine flu strain was similar to the one responsible for the 1918-19 pandemic, which killed half a million Americans and 20 million people worldwide.

Within days, symptoms of GBS were reported among those who had been immunised and 25 people died from respiratory failure after severe paralysis. One in 80,000 people came down with the condition. In contrast, just one person died of swine flu.

More than 40 million Americans had received the vaccine by the time the programme was stopped after ten weeks. The US Government paid out millions of dollars in compensation to those affected.

The swine flu virus in the new vaccine is a slightly different strain from the 1976 virus, but the possibility of an increased incidence of GBS remains a concern.

Shadow health spokesman Mike Penning said last night:

‘The last thing we want is secret letters handed around experts within the NHS. We need a vaccine but we also need to know about potential risks. ‘Our job is to make sure that the public knows what’s going on. Why is the Government not being open about this? It’s also very worrying if GPs, who will be administering the vaccine, aren’t being warned.’

Two letters were posted together to neurologists advising them of the concerns...

If there are signs of a rise in GBS after the vaccination programme begins, the Government could decide to halt it.

GBS attacks the lining of the nerves, leaving them unable to transmit signals to muscles effectively. It can cause partial paralysis and mostly affects the hands and feet. In serious cases, patients need to be kept on a ventilator, but it can be fatal. Death is caused by paralysis of the respiratory system, causing the victim to suffocate. It is not known exactly what causes GBS and research on the subject has been inconclusive. However, it is thought that one in a million people who have a seasonal flu vaccination could be at risk and it has also been linked to people recovering from a bout of flu of any sort.

The HPA said it was part of the Government’s pandemic plan to monitor GBS cases in the event of a mass vaccination campaign, regardless of the strain of flu involved. But vaccine experts warned that the letters proved the programme was a ‘guinea-pig trial’...

In India Swine Flu Hysteria Spreads Faster Than Virus

August 14, 2009

AP (New Delhi, India) - The streets of the western city of Pune were half-empty, schools in Mumbai were ordered closed, and people suffering aches flooded hospitals across the country as India confronted dueling outbreaks of swine flu and swine flu panic.

Twenty one people have died from the flu here, the government said Friday, and 1,390 have been confirmed infected in this nation of 1.2 billion people. But fear of the flu has outpaced the virus itself.

“The amount of frenzy or hysteria is totally disproportionate to the overall reality of the disease,” Dr. Jai Narain, the head of the regional communicable disease office for the World Health Organization, said Friday.

Breathless reports of swine flu have dominated India’s 24-hour news channels desperate for stories amid the August doldrums. That in turn has helped whip the public into a frenzy, even in cities with relatively few cases of flu.

In New Delhi, where no deaths have been reported, people have begun wearing surgical masks in the street. In Lucknow, parents demanded their children be tested.

“Over 1,000 people lined up at different hospitals. … Eleven of them tested positive,” Dr. R.R. Bharati, a top health official in the northern city of Lucknow said earlier this week.

In Mumbai, the country’s financial capital, the government closed all schools and movie theaters, hammering the Bollywood film industry over the long Independence Day holiday weekend. The government also asked malls in Mumbai to tone down their traditional holiday sales to keep away crowds.

The nearby city of Pune is India’s worst affected, with 13 of the country’s 21 deaths. There, the streets were half-empty, the usual crowds shunned the shopping malls and many workers stopped showing up at offices. With schools closed, worried parents kept their children shut inside. Many who did venture out wore surgical masks, despite a shortage that sent the price of a single mask skyrocketing from 5 rupees (10 cents) to 150 rupees ($3).

“The situation in Pune is alarming considering the number of … positive cases and deaths. We are augmenting the resources in the city to handle the situation. However, we appeal to people not to panic,” said Chandrakant Dalvi, a city official.

In response to the outbreak, India’s government has set up testing centers around the country and plans to increase its stock of the anti-viral drug Tamiflu to 30 million doses, the government said. But officials have also asked people to stop wearing surgical masks in the street unless they or a family member are infected.

“I cannot see anything to panic about,” said Dr. Jayaprakash Muliyil, a professor of epidemiology at Christian Medical College in Vellore. “These kinds of rumors are not good for the health of the nation.”

The fatality rate from the virus is relatively low, though scientists worry it could eventually mutate into a more deadly strain, he said.

Yet the flu has garnered far more attention than India’s raft of other health problems, including tuberculosis, which kills nearly 1,000 Indians every day, according to World Health Organization figures...

Swine Flu May Not Be Any Deadlier This Fall: Experts

August 12, 2009

U.S. News & World Report - The theory that a relatively mild outbreak of a new flu virus in the spring predicts a more severe, deadly outbreak in the fall isn’t borne out by a look back at prior epidemics, two U.S. experts say.

“Pandemic history suggests that changes neither in transmissibility nor in pathogenicity are inevitable,” concluded Drs. David Morens and Jeffery Taubenberger, infectious disease experts at the U.S. National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

In an article published in the Aug. 12 issue of the Journal of the American Medical Association, the experts take on a much-publicized theory that’s helped stoke fears about a resurgence of swine flu in the Northern Hemisphere this fall.

The so-called “herald wave” theory stems from the belief that the deadly 1918-19 flu pandemic began with a milder spring wave of illness, which got more deadly as the virus spread throughout the summer, picking up lethal mutations. The 1918-19 “Spanish Flu” is estimated to have killed between 20 million and 40 million people worldwide...

Nearly 3,000 People Line Up for Experimental H1N1 Vaccine

August 10, 2009

The Early Show - Hundreds of Americans in eight cities are lining up for experimental swine flu shots in a race to get a vaccine out before the new flu virus sweeps the U.S. this fall.

Sharon Frey, who is leading the government-funded testing at Saint Louis University, said scientists have been working late nights and weekends to organize the studies and recruit volunteers.

"Typically it takes a year to do this," said Frey, an infectious diseases expert. "I can tell you we're working at breakneck speed."

About 2,800 people will participate in the government-led studies. Saint Louis University will test 200 adults and 200 children. Also under way are separate studies by five flu vaccine manufacturers under contract with the government.

Health officials expect to have about 160 million doses available this fall, with the first batch sometime in September. The studies will test the safety and effectiveness of vaccines developed by drug makers and help determine dosage and whether it can be given with a seasonal flu shot.

Participants will be given different combinations of two swine flu vaccines made by drug makers Sanofi Pasteur and CSL Limited and a seasonal flu vaccine.

It's possible the government will begin a public vaccination campaign before all of the work of the trials is complete, Dr. Anne Schuchat has said. She oversees the flu vaccination programs at the Centers for Disease Control and Prevention.

Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, the government wants to carefully monitor people who get the new vaccine for any problems.

Nicholas Sarakas, 25, of St. Peters, Mo., is among the vaccine volunteers. As a young adult, he's among the groups targeted for the swine flu vaccine; swine flu has been harder on younger people than their elders.

"I thought, 'I'll end up getting a flu shot anyway,'" he said. "Somebody has to be the first person to try it."

The other study sites are Baylor College of Medicine in Texas, Children's Hospital Medical Center in Cincinnati, Emory University, Group Health Cooperative in Seattle, University of Iowa, University of Maryland School of Medicine and Vanderbilt University.

British National Health Service Has 16 Year-Old Students Handing Out Flu Drugs

August 8, 2009

Daily Mail (England) - An NHS call centre is employing 16-year-olds to assess suspected cases of swine flu. They earn up to £16.40 an hour reading out a prepared script of questions. It is their responsibility to hand out powerful anti-viral drugs such as Tamiflu – known to have violent side-effects.

The revelation comes amid concerns that problems with the phone hotline are leading to incorrect diagnoses. At least eight pupils from the same school are among 15 youngsters employed at the pandemic hotline call centre in Watford. Many have been working late into the night, in contravention of employment law guidelines for under-18s.

A source said last night: ‘Some of the kids are just so young I would be surprised if they could even spell the word pandemic.’Liberal Democrat health spokesman Sandra Gidley called the news worrying.

‘Expecting people with little or no experience to work on such a complex subject is irresponsible,’ she said.

‘It’s bad enough that people can answer three questions and bingo, you get Tamiflu. The danger is that the Government, far far from being prepared as it claimed, is actually rushing things through in a way that is bad for the public.’

The call centre held a weekend of job interviews to find 800 part-time staff to supplement 200 existing full-time workers. Some 5,000 people queued outside the headquarters of NHS Professionals, lured by £10 an hour on weekdays and £16.40 at weekends. It is one of 19 centres set up in July after Health Secretary Andy Burnham announced a National Pandemic Flu Service...

The new staff were given three hours of training in how to read a prepared script of questions to discover whether a caller – or a member of their family – was exhibiting swine flu symptoms. If the caller answers yes to a certain number of questions, the call centre worker can suggest taking Tamiflu.

Callers are given an authorisation number which they hand to a ‘flu friend’ who can pick up the anti-viral from a collection point. But an insider claimed that operators were advising higher numbers of people to get Tamiflu ’so they could show they were working hard’...

The revelation that GCSE students are diagnosing flu comes just days after nine out of ten family doctors said they feared phone diagnosis would lead to serious diseases being missed...

Rapid Tests to Diagnose Swine Flu are Often Wrong

August 6, 2009

AP - The government's first study of how well rapid tests diagnose swine flu finds they're wrong at least half the time.

The Centers for Disease Control and Prevention looked at rapid tests made by three companies. The tests correctly confirmed swine flu infections only 10 percent to 51 percent of the time. The tests were better at diagnosing seasonal flu.

What should doctors do if a test comes back negative for a patient they think has the flu? The CDC says doctors should order a more precise lab test but in the meantime prescribe medicines like Tamiflu.

The results of the study were released Thursday.

Brochure - International Swine Flu Conference to Be Held in Washington Aug 19 – Aug 21, 2009