ALERT Comprehensive Flu Thread, Latest reports, States, Countries, Closings.

[Tom McDowell]

California

Family: Hospital Did Not Disclose Daughter's H1N1 Diagnosis
Aby Aguiniga, 16, Is County's First Teen Swine Flu Fatality

POSTED: 5:46 pm PST December 11, 2009
UPDATED: 6:02 pm PST December 11, 2009

http://www.10news.com/news/21946524/detail.html

SAN DIEGO -- A South Bay family mourning the loss of their 16-year-old daughter told 10News they were not made aware of their daughter's swine flu diagnosis.

Montgomery High School student Aby Aguiniga was identified as the first teen to die of swine flu after 10News matched a San Diego County news release against death records.

On Thursday, Montgomery High School helped 10News arrange an interview with Aby's father to thank classmates for helping with funeral costs.

However, as the interview unfolded it became apparent eight days after Aby's death, Ruben Aguiniga did not know the true cause of death.

While Aby did suffer flu-like symptoms, Aguiniga said he was told by doctors at Rady Children's Hospital that his daughter, who lived with Down syndrome, likely died of a heart condition.

"I can't believe it. This is terrible. We have several young children and grandchildren in our home. We need this information," said Aguiniga.

According to county health officials, an initial positive test result for swine flu was sent to the hospital on November 25. Confirmation of the diagnosis was sent on November 29, several days before Aby died.

The Aguiniga family said they were never told, and Children's Hospital officials said they are looking internally to find out why.

Additionally, county officials admitted they should never have released any information to the media without confirming the hospital had told the family.

10News learned a mix-up of patient files prompted a county employee to authorize the release of the information, which led to a grieving family learning why Aby died during the interview.

County health officials issued the following statement: "We regret the error and any resulting distress the family may have experienced."

Rady Children's Hospital officials told 10News: "Our hearts go out to the family. If we find any wrongdoing on our part, we will correct it."

The Aguiniga family told 10News everyone in the family, including the other children in the home, is doing well physically.

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[Tom McDowell]

Illinois

9 new swine flu deaths in Ill.
December 11, 2009
THE ASSOCIATED PRESS

http://www.southtownstar.com/news/1934050,swine-flu-illinois-1211.article


Illinois health officials are reporting nine new deaths and 216 new hospitalizations from swine flu.

The new deaths bring the total number of Illinois deaths from the virus to 76 since April. Hospitalizations have topped 2,400.

The global epidemic is affecting younger adults more than the elderly. More than two-thirds of the Illinois deaths were among people ages 19 to 64.

Nearly 2.6 million doses of swine flu vaccine have been shipped to Illinois. There's now enough vaccine to go around, so Illinois health officials have said they're broadening recommendations on who can get it.

Everyone older than 6 months can get the vaccine beginning Tuesday - not just those in high-risk groups. Many retail pharmacies are expected to receive vaccine this month.

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[Tom McDowell]

Montana

Health officials urge more access to swine flu vaccine;
state death count at 18


Associated Press | Posted: Friday, December 11, 2009 12:25 pm |

http://www.missoulian.com/news/state-and-regional/article_38a3f7e8-e68b-11de-86f0-001cc4c002e0.html

HELENA - State health officials are recommending local and tribal health departments expand access to the swine flu vaccine after announcing that 18 Montanans have died from complications related to the virus.

The Department of Public Health and Human Services said Friday the vaccine supply is sufficient enough to support health departments that want to vaccinate those outside the at-risk groups and local health departments should provide the vaccine to the general public.

The health department said earlier this week that nearly all the victims who died of swine flu-related complications were adults with pre-existing medical conditions.

Several county health departments have already announced they will make the vaccine available to the general public.

"The priority groups are still important," said Anna Whiting Sorrell, director of the DPHHS. "And we continue to encourage those who are at risk to come in for their vaccine."

People most at risk for complications are pregnant women or those with chronic conditions such as diabetes, heart disease, asthma or other conditions that reduce immunity to influenza. Other groups that are at higher risk of infection or to spread the virus to vulnerable populations are health care workers, people between the ages of 6 months and 24 years and caregivers of children ages 6 months and younger.

Health departments in Missoula, Yellowstone, Butte-Silver Bow, Flathead and Ravalli counties announced this week that they will make the vaccine available to the general public.

People may receive both the swine flu shot and the seasonal flu shot on the same day, said Flathead County Health Officer Joe Russell.

"This is an ideal time to be vaccinated for protection against influenza during the holidays, as it takes up to two weeks before influenza immunizations are fully effective."

Whiting Sorrell said many of the deaths occurred before enough H1N1 vaccine was available.

"However, now the H1N1 vaccine supply has recently increased to the point that more of these high-risk persons can be vaccinated," she said.

Montana recently received 39,000 doses of the H1N1 vaccine, bringing the total to nearly 264,000 doses received since October.

The agency also reported the death rate for H1N1 infection is higher among American Indians than Caucasians. In Montana, five American Indians have died, for a death rate of 7.6 per 100,000, compared with 1.5 per 100,000 for Caucasians.

The Centers for Disease Control and Prevention used data from 12 states, not including Montana, and found the swine flu death rate for American Indians is four times higher than that for non-Indians in those states at 3.7 per 100,000, compared with 0.9 per 100,000.

The reasons for the difference are not known, but a likely contributing factor is the higher prevalence of diabetes and asthma among American Indians. A higher prevalence of those predisposing health conditions in middle-aged and older adults likely contributes to the difference in death rates among ages groups in Montana, as well, the agency said.


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[Tom McDowell]

Iowa

Bluffs toddler falls victim to infections

Hospital & Medical Center in Omaha.
By TIM JOHNSON, Staff Writer
tjohnson@nonpareilonline.com
Published: Friday, December 11, 2009 11:28 AM CST

http://www.southwestiowanews.com/articles/2009/12/11/council_bluffs/doc4b2273d47fd49460991343.txt


“I never thought it would happen to me – ever. He was my only child.”

Submitted photo - Jason Johnson, age 2 1/2, died Monday at Children’s

Sandra Walls of Council Bluffs was still in shock Tuesday when she described how her son, Jason Johnson, age 2 1/2, had died Monday at Children’s Hospital & Medical Center in Omaha.

Jason started experiencing symptoms Thursday, she said. On Saturday morning, he was vomiting and had a fever of 104.5 degrees. They took him to a local health care provider.

“They said it was just a virus,” she said. “They just told us it was a virus, give him Tylenol and Motrin and go home.”

By that night, Jason was no longer able to breathe on his own, Walls said.

“We ended up calling 9-1-1, because I went into the bedroom and he was blue,” she said.

The ambulance took him to Jennie Edmundson Hospital, where he was kept on a ventilator until he could be transported to Children’s Hospital.

“Sunday, they did some tests at Children’s and said he was brain-dead,” Walls said. “They kept him on (the ventilator and IVs) for 24 hours and checked him again and said he was brain-dead – and he died about 3:15 (p.m.).”

*
Ultimately, it was pneumonia and a strep infection that caused Jason’s death, according to the Council Bluffs Public Health Department. Walls and Jason’s father, Brian Johnson, were surprised that Jason’s illness took such a sharp turn for the worse, she said.

“I just want to tell parents, when they say it’s just a virus infection, not to settle for that answer,” she said. “Make sure they do tests and tell you what’s wrong with your child.”

While Jason’s parents did have health insurance to help pay for his hospital expenses, they are asking friends and supporters to help with other costs. Donations may be designated for the Jason Lee Johnson Memorial Fund and mailed or taken to any First National Bank branch, including the Metro Crossing Branch at 3815 Denmark Ave., Council Bluffs, IA 51503.


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[Tom McDowell]

North Carolina

Young Wilmington mother’s life lost to H1N1

By Vicky Eckenrode
Vicky.Eckenrode@StarNewsOnline.com

Published: Saturday, December 12, 2009 at 3:30 a.m.

http://www.starnewsonline.com/article/20091212/ARTICLES/912119951/1004?p=1

When Tanya Marie Murray began feeling sick on Halloween, her family thought she had a bad flu.

It wasn’t until after multiple trips to the emergency department, eventually getting rushed to the intensive care unit and being put on a respirator that it became clear how serious Murray’s situation was.

Murray, a 30-year-old Wilmington resident, struggled in the ICU for days before dying Nov. 12 of complications related to the H1N1 virus.

“It’s not real, for someone so full of life and just so loving and so caring, and she’s just taken so quickly,” said her sister, Tabatha VanVliet, who also lives in Wilmington. “She was going by what you’re supposed to do. You’re told if you don’t feel well, you go to the doctor.”

Murray, the mother of a 7-year-old boy, began feeling bad on Halloween and continued to get worse, VanVliet said.

She went to Cape Fear Hospital a couple of days later where doctors said she had the flu.

Murray had trouble breathing, a cough, sore throat and a fever. She went back two days after and was told she had pneumonia, was given antibiotics and went home, VanVliet said.

“She couldn’t keep the antibiotics down,” she said.

By the end of the week, Murray called her family. She had woken up after passing out in her hallway, not knowing how she got there or how long she had been there. Family members took her to New Hanover Regional Medical Center’s emergency department where they said they were told it would take eight hours to be seen. So instead, they went back to Cape Fear.

A representative from New Hanover Regional was not available last week to be interviewed.

“At that point, I was concerned, but I didn’t know what it was,” VanVliet said, adding she and Murray had joked about swine flu when she began getting sick but never in a million years thought that’s what was infecting her lungs.

“Until this happened to her I didn’t think twice about it,” VanVliet said about the virus.

Before then, most of what VanVliet said she had heard about the H1N1 virus in the media and from other people was that most of the people getting it experienced something slightly worse than the regular seasonal flu – something that kept people at home from work or school for a couple of days but didn’t send them to the hospital to fight for their lives.

“I just thought it was a bad pneumonia,” VanVliet said about her sister’s condition.

While at Cape Fear, doctors made the decision to transport Murray to New Hanover Regional.

“As soon as she got to New Hanover’s ICU, they (doctors) came out and they told us that her only chance would be to be on a respirator,” VanVliet said. “We went in to see her. That’s when they told her and she was terrified.

“They told her that she had to be on the respirator so they could give her everything that they could that night.”

With Murray’s oxygen levels and blood pressure getting dangerously low, family members kept vigil. She got better for a little while, but a within days her kidneys stopped working, and she was put on dialysis, VanVliet said.

Less than two weeks after first feeling symptoms and a week after being admitted to the hospital, Murray took a turn for the worse.

“When we got to New Hanover, the doctors said she had classic H1N1 symptoms,” VanVliet said. “From the time they told us that’s what it was it was too late.”

According to Murray’s death certificate, H1N1 influenza pneumonia and respiratory failure caused her death. Kidney failure also was a contributing factor.

Though the flu strain has circulated nationally since the spring, it was not until about the time when Murray got sick this fall that the first area deaths associated with the virus happened. At least a handful of people in the area with the virus have died.

Since the spring, 74 people have died in North Carolina from the flu, predominantly from the H1N1 strain.

Reports of flu-like illnesses appear to be on the decline now in North Carolina, though national health experts are divided on whether there will be another spike during the traditional flu season this winter.

Emergency department visits and hospitalizations statewide for flu-like illnesses have dropped off since October, when there was a peak in activity.

VanVliet said her sister did not have any other chronic medical conditions.

At the age of 30, Murray was outside the priority groups to qualify for the initial H1N1 vaccines. The age cut off was 24 unless someone had certain medical conditions so that the limited supplies could be targeted at groups health officials considered to be at high risk to suffer complications from the virus.

State health officials last week announced the vaccines could be opened up to anyone who wants one now that supplies have gone to priority groups, and local health departments have expanded their vaccine clinics.

VanVliet said she doesn’t know if her sister, who had previously worked as a certified nursing assistant, had wanted to get the vaccine or not.

VanVliet said she is left wondering whether earlier intensive treatment and the ability to diagnosis the H1N1 virus earlier would have made a difference.

“It’s just frustrating,” she said. “She was full of energy, would do anything and everything for people. She loved to spend time with her son. She just had so much in life left to go for.”

Vicky Eckenrode: 343-2339

On Twitter.com: @vickyeckenrode


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[Be Well]

http://www.recombinomics.com/News/12130901/D225G_H274Y_IL.html

Commentary

D225G and H274Y in Illinois Case
Recombinomics Commentary 18:13
December 13, 2009

Recent reports of increased Tamiflu resistance, coupled with a strong associate of two receptor binding domain changes, D225G and D225N, has raised concerns that the two polymorphisms may be recombining to generate a lethal H1N1 that is Tamiflu resistant. Interest in the two receptor binding domain changes was increased dramatically by results from Ukraine which had one of these changes in six of six fatal cases. The reports on D225G led France to check prior cases and D225G was found in two fatal cases. Of concern was the finding of H274Y in one of those cases.

A review of recently released sequences has found the same combination in sequences deposited by the CDC at GISAID. The isolate, A/Illinois/11/2009, was collected on July 31, which is during the same time frame as the train ride in Vietnam that led to at least seven cases of H274Y. In July/August the receptor binding domain changes were noted in fatal cases in Sao Paulo.

The increases in detection of H274Y have been reported by the WHO and CDC in recent weeks. In the US, four of ten cases were fatal, while in the Netherlands, four of eleven cases were fatal. However most of these sequences as well as those from the Vietnam train in July have not been released.

An increase in surveillance for these markers as well as the prompt release of sequences would be useful.

 

[Be Well]

Monotreme's new blog - there are embedded links in the article if you read it on PFI or his blog:

http://www.singtomeohmuse.com/viewtopic.php?t=92&start=2970


Frog Soup – Complacency in the face of extreme danger

I have participated in online forums related to pandemic influenza for years. Like many participants in “Flublogia”, I have tried to prepare for a worst case scenario, a highly lethal flu virus, like H5N1, that spreads readily human to human. Thus far, this has not happened. The current pandemic H1N1 is a nasty virus that is estimated by the CDC to have already killed over 1,000 American children. It may kill many more children, and adults, before it becomes a “normal” seasonal flu virus. I think that the CFR of this virus is much higher than seasonal flu, especially in people younger than 65. However, pandemic H1N1 does not have a CFR that exceeds 1 or 2%, even in countries with little access to Tamiflu or vaccine. In countries with anti-virals and vaccines, the CFR is likely to be less than 1%, assuming no change in the virus.

Is that a reasonable assumption?

No, in my opinion.

There is already evidence that Tamiflu-resistant strains are becoming more common. And evasion of vaccines due to antigenic drift is a specialty of flu viruses. That is, after all, why we need a new vaccine every year. As dangerous as a virus would be without effective antivirals or vaccines to combat it, there is a bigger danger – a hybrid with H5N1.

A number of public health authorities in Asia have recently expressed concern about this possibility, most recently in Vietnam.

From VNA, December 12, 2009 [hat-tip, treyfish for the machine translation]

Director Nguyen Huy Nga also make recommendations, winter weather makes progress Complicatedly influenza A/H1N1 and more dangerous. Especially with the recurrence of avian influenza H5N1, the risk of recombinant H1N1 influenza virus with the H5N1 strain variables have a pathogenic virus spread is strong and huge.

In my opinion, the odds that an H5N1 hybrid that can spread easily will be formed has never been higher. Yet, concern about such outcome among the general public has probably never been lower.

Most people get their information about the world from television. For many, TV is reality. If newscasters tell them the flu is dangerous, they will be concerned. However, if they are told that the current pandemic is mild or there are simply no English language stories at all about the increasing likelihood of a dangerous hybrid virus, few will seek out information on their own. Fewer still will prepare for a true worst case scenario.

The thing is, flu viruses don’t care whether anyone is watching what they do. It doesn’t matter to them if the MSM is tired of the pandemic story. Nor do they care if even veteran flu watchers are experiencing pandemic fatigue and don’t want to think about it anymore. Flu viruses will go about their business of mutating, spreading, and possibly exchanging genetic material.

Experiencing extreme anxiety every time there was an outbreak of H5N1 was not healthy, in my opinion. But nor is ignoring what is likely the greatest risk we have experienced to date.

 

[Tom McDowell]

14 States Reporting Widespread H1N1
CDC: Only 14 states now reporting widespread swine flu cases, regular flu picking up.
Content courtesy of the Associated Press

11:05 a.m. CST, December 11, 2009

http://www.chicagotribune.com/features/sns-health-swine-flu-14-states,0,511995.story


Health officials say winter flu is just starting to show up in the U.S. while swine flu infections continue to wane.

Swine flu was widespread in only 14 states last week; mostly in the Northeast. That's down from 25 states the week before and 48 in late October. The Centers for Disease Control and Prevention released the new data Friday.

CDC officials said a shortage of swine flu vaccine is easing, with 85 million doses now available. About 98 percent of lab-confirmed influenza cases last week were swine flu, but the CDC also noted seasonal flu is increasing slightly.

The regular flu usually peaks in the winter.

The report from the CDC.

from the report:

Fourteen states are reporting widespread influenza activity; a decline of 11 states from last week. They are: Alabama, Alaska, Arizona, California, Connecticut, Delaware, Kentucky, Maine, New Hampshire, New Jersey, New York, Rhode Island, Vermont, and Virginia

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[Tom McDowell]

Prolonged shedding of swine flu virus

Posted on: December 13, 2009 2:00 PM, by revere

http://scienceblogs.com/effectmeasu...aign=Feed:+scienceblogs/AyaJ+(Effect+Measure)

Red wine has been touted for its health benefits but these don't seem to extend to warding off swine flu. The virology laboratory in Bordeaux in the southwest of France tested via RT-PCR over 1200 nasopharyngeal swabs between May 1 and the first week in October and found 186 positive for the new pandemic strain. They looked at five of these cases more closely, monitoring them for duration of viral shedding. Two of the five kept shedding for 2 to 4 weeks (paper in Eurosurveillance by Fleury et al., v. 14, #49, December 10, 2009).

The first case was a non-obese previously healthy male in his mid fifties. Shortly after returning to France from California in the beginning of July he developed fever and had difficulty catching his breath. Within a day he was in the intensive care unit. A swab was positive for the presence of the swine flu virus. He was started on the recommended dose of oseltamivir (Tamiflu, 150 mg daily) and improved rapidly. He was soon transferred out of the ICU, but repeat swabs showed he was continuing to shed virus. Oseltamivir was continued and then changed to zanamivir (Relenza). He continued to shed virus for another 7 days, until day 15, when he was discharged. He was evaluated for immunosuppressive illness and found not to have any signs of one.

The second case was a morbidly obese (BMI over 50) woman in her late twenties, just returned from Spain in late July. She had flu-like symptoms for 5 days while at home but began to deteriorate and wound up in an intensive care unit on 31 July. A nasopharyngeal swab revealed the presence of the virus and she, too, was started on oseltamivir at the recommended dose. Her conditioned worsened and she developed acute respiratory distress syndrome (ARDS) and was put on a ventilator and then extracorporeal membrane oxygenation (ECMO), essentially a heart lung machine that allows the blood to get oxygen without requiring the lungs to work. Oseltamivir was increased to a double dose (300 mg per day) on 2 August. Her condition allowed deep respiratory secretions to be obtained and they remained positive for the virus for 13 samples (19 days). Of interest was that nasopharyngeal swabs were negative when deep lung secretions were positive in this patient. Virus continued to be detected until day 31 after symptom onset. Miraculously, this critically ill woman with a major risk factor made a full recovery and left the hospital at the beginning of September. She, too, was evaluated for immunosuppressive conditions but no sign of one was found.

What about the virus? These patients were treated intensively with the antiviral neuriminidase inhibitors but had prolonged viral shedding, although both did well clinically. The viral isolates were checked for the main mutation that confers resistance (H274Y) and neither had it. The virus was apparently sensitive to the drugs. So there was no apparent explanation for why these patients continued to shed virus for much longer than the usually claimed period of 5 to 7 days from onset. This was despite the use of antivirals which in experimental challenge studies with human volunteers have cut the length of viral shedding in half (a median of 107 hours to 58 hours). Prolonged viral shedding can occur in children and the immunocompromised, but that describes neither of these patients.

There is data on viral shedding in influenza but not a great deal of it. Our guess is that the previous estimates, based on rather small samples, do not adequately account for a substantial number of prolonged shedders there might be when millions of people are infected. Even if prolonged shedding occurs infrequently, say in one in a thousand cases, this could still produce thousands of people who continue to shed influenza virus for weeks after they are apparently recovered.

It may be that people can continue to harbor infection and even shed virus to some extent, but not enough to infect others. It's another of the many things we don't know about flu. But now we know that prolonged shedding of virus can and does occur. We just don't know what it means.

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[summerthyme]

I hate being picky, but WHAT in hell does the first sentence have to do with ANYTHING else in this interesting article?????

Is it assumed that *everyone* who lives in the Bordeaux region automatically drinks several glasses of red wine daily, or what?

I really hate articles which throw out what amounts to a total non sequitur- apparently as a "teaser" to get people to read otherwise "dry" information!

Summerthyme

 

[Be Well]

Health officials say winter flu is just starting to show up in the U.S. while swine flu infections continue to wane.

Nowhere in the article is there evidence that anyone has tested positive for seasonal flu; I wonder if their assertion that "winter flu" is starting is backed by any testing evidence?

 

[summerthyme]

Nowhere in the article is there evidence that anyone has tested positive for seasonal flu; I wonder if their assertion that "winter flu" is starting is backed by any testing evidence?

Evidence? What's dat? We don't need no stinkin' evidence...

Heck, I want to know how they know "H1N1 is declining" if "98% of lab tested influenza cases were H1N1 last week"!!!

Does ANYONE proof read what they write these days, or even have any critical thinking skills?

Summerthyme

 

[Catbird]

After a long hiatus, mostly due to health issues, I found my way back and was glad to see this thread still on the front page!

Thanks for all the hard work!!!

I'm just sorry I couldn't stick with y'all.

I'm pretty far behind on H1N1 news but can relate my own experience with the vaccine. I've finally been diagnosed with ideopathic anaphylaxis (the above mentioned health issue) and my immunologist stressed the importance of my getting the vaccine due to complications of my disease. So last week, I went to my county Health Dept., where they've finally gotten some vaccine and was told (after the staff had a 15 minute huddle) that they wouldn't give it to me because I react to gluten and the vaccine contains gelatin. Vegetable based gelatins (as opposed to animal) often contain gluten as a thickening/stabilizing agent.

So heads up to anyone out there with gluten issues. If you haven't already thought twice about getting the vaccine - think long and hard about whether it's worth the risk.

 

[BlueNewton]

Prolonged shedding of swine flu virus

Posted on: December 13, 2009 2:00 PM, by revere

http://scienceblogs.com/effectmeasu...aign=Feed:+scienceblogs/AyaJ+(Effect+Measure)

Red wine has been touted for its health benefits but these don't seem to extend to warding off swine flu. The virology laboratory in Bordeaux in the southwest of France tested via RT-PCR over 1200 nasopharyngeal swabs between May 1 and the first week in October and found 186 positive for the new pandemic strain. They looked at five of these cases more closely, monitoring them for duration of viral shedding. Two of the five kept shedding for 2 to 4 weeks (paper in Eurosurveillance by Fleury et al., v. 14, #49, December 10, 2009).

The first case was a non-obese previously healthy male in his mid fifties. Shortly after returning to France from California in the beginning of July he developed fever and had difficulty catching his breath. Within a day he was in the intensive care unit. A swab was positive for the presence of the swine flu virus. He was started on the recommended dose of oseltamivir (Tamiflu, 150 mg daily) and improved rapidly. He was soon transferred out of the ICU, but repeat swabs showed he was continuing to shed virus. Oseltamivir was continued and then changed to zanamivir (Relenza). He continued to shed virus for another 7 days, until day 15, when he was discharged. He was evaluated for immunosuppressive illness and found not to have any signs of one.

The second case was a morbidly obese (BMI over 50) woman in her late twenties, just returned from Spain in late July. She had flu-like symptoms for 5 days while at home but began to deteriorate and wound up in an intensive care unit on 31 July. A nasopharyngeal swab revealed the presence of the virus and she, too, was started on oseltamivir at the recommended dose. Her conditioned worsened and she developed acute respiratory distress syndrome (ARDS) and was put on a ventilator and then extracorporeal membrane oxygenation (ECMO), essentially a heart lung machine that allows the blood to get oxygen without requiring the lungs to work. Oseltamivir was increased to a double dose (300 mg per day) on 2 August. Her condition allowed deep respiratory secretions to be obtained and they remained positive for the virus for 13 samples (19 days). Of interest was that nasopharyngeal swabs were negative when deep lung secretions were positive in this patient. Virus continued to be detected until day 31 after symptom onset. Miraculously, this critically ill woman with a major risk factor made a full recovery and left the hospital at the beginning of September. She, too, was evaluated for immunosuppressive conditions but no sign of one was found.

What about the virus? These patients were treated intensively with the antiviral neuriminidase inhibitors but had prolonged viral shedding, although both did well clinically. The viral isolates were checked for the main mutation that confers resistance (H274Y) and neither had it. The virus was apparently sensitive to the drugs. So there was no apparent explanation for why these patients continued to shed virus for much longer than the usually claimed period of 5 to 7 days from onset. This was despite the use of antivirals which in experimental challenge studies with human volunteers have cut the length of viral shedding in half (a median of 107 hours to 58 hours). Prolonged viral shedding can occur in children and the immunocompromised, but that describes neither of these patients.

There is data on viral shedding in influenza but not a great deal of it. Our guess is that the previous estimates, based on rather small samples, do not adequately account for a substantial number of prolonged shedders there might be when millions of people are infected. Even if prolonged shedding occurs infrequently, say in one in a thousand cases, this could still produce thousands of people who continue to shed influenza virus for weeks after they are apparently recovered.

It may be that people can continue to harbor infection and even shed virus to some extent, but not enough to infect others. It's another of the many things we don't know about flu. But now we know that prolonged shedding of virus can and does occur. We just don't know what it means.

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This is one of the most important articles that has been posted on this thread!

 

[Cascadians]

Catbird, don't worry, you're not missing anything. I got the H1N1 vaccine and 13 days later got the swine flu for the 4th time. Thing's worthless, and H1N1 is mutating beyond the vaccine. If you feel your diagnosis is accurate, congrats! now you'll learn how to best cope.

 

[Tom McDowell]

Originally Posted by Be Well View Post
Nowhere in the article is there evidence that anyone has tested positive for seasonal flu; I wonder if their assertion that "winter flu" is starting is backed by any testing evidence?

Sorry, should have copied that section too. - from the above linked CDC report pdf:

The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report increased over the previous week and has been higher than expected for ten consecutive weeks. In addition, 16 flu-related pediatric deaths were reported this week:

13 of these deaths were associated with laboratory confirmed 2009 H1N1, 2 were associated with influenza A viruses that were not subtyped and one was associated with a seasonal influenza B virus.

Since April 2009, CDC has received reports of 267 laboratory-confirmed pediatric deaths: 224 due to 2009 H1N1, 41 pediatric deaths that were laboratory confirmed as influenza, but the flu virus subtype was not determined, and two pediatric deaths were associated with seasonal influenza viruses. (Laboratory-confirmed deaths are thought to represent an undercount of the actual number. CDC has provided estimates about the number of 2009 H1N1 cases and related hospitalizations and deaths. The increase in the proportion of deaths as other indicators are going down is not surprising as the occurrence and reporting of deaths usually lags behind that of other indicators.


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Granted it's a bit thin, then again, if there's one death there's some B type floating around. OTOH perhaps yet another spin measure as reported via the MSM, lessening of the physiological impact. It's only the flu.

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[Be Well]

Thank you, Tom. So a bit of B. I bet you anything there is no type A other than swine.

 

[Tom McDowell]

Via Rhiza

the Claim: Flu Viruses Live Longer on Surfaces Than Cold Viruses.
By ANAHAD O’CONNOR

December 15, 2009

http://www.nytimes.com/2009/12/15/health/15real.html?_r=1

THE FACTS Most people know that cold and flu viruses can contaminate doorknobs, faucets and other surfaces. But for how long?

Studies have found that the survival time for both kinds of viruses varies greatly, from a few seconds to 48 hours. The reasons have to do with a number of factors, including the type of surface, humidity and temperature.

For example, cold and flu viruses survive longer on inanimate surfaces that are nonporous, like metal, plastic and wood, and less on porous surfaces, like clothing, paper and tissue. Most flu viruses can live one to two days on nonporous surfaces, and 8 to 12 hours on porous surfaces. But a 2006 study found that avian influenza seemed particularly hardy, surviving as long as six days on some surfaces.

Cold viruses, however, deteriorate quickly. A study in 2007 found that when objects in a hotel room — light switches, telephones — were contaminated with a cold virus, 60 percent of healthy volunteers picked up the virus when they touched one of the objects an hour later. Eighteen hours later, the transmission rate was cut in half.

On skin, cold and flu viruses generally last less than a few minutes, but that can be plenty of time: studies show that most people touch their hands or mouth several times in the course of daily activities — enough to cause infection.

THE BOTTOM LINE Flu viruses tend to survive longer than cold viruses.

ANAHAD O’CONNOR scitimes@nytimes.com

scitimes@nytimes.com


===

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[Tom McDowell]

California

5 more H1N1 deaths bring O.C. toll to 49
December 14th, 2009, 2:50 pm · 14 Comments · posted by Landon Hall

(Updated at 6:35 p.m. with comment from CHOC doctor.)

http://healthyliving.freedomblogging.com/2009/12/14/5-more-h1n1-deaths-bring-oc-toll-to-49/14183/

Five more people in Orange County died of swine flu last week, bringing the death toll to 49 since the pandemic began in April, the county’s Health Care Agency said Monday.

All five of the victims were adults who had pre-existing health conditions that made them more vulnerable to the virus, HCA spokeswoman Tricia Landquist said.

Such conditions could include heart disease; asthma and other respiratory disorders; obesity and diabetes. Most of the fatalities so far have had such underlying health problems, although some people hit hard by H1N1 were perfectly healthy, such as this 4-year-old boy who spent 29 days in the hospital and survived.

The county has declined to release personal information about the fatalities, but here are some details:

* The age range is between under 1 year to 93 years.
* The median age is 53.
* The toll includes five children under 18.
* The toll includes three pregnant women.

Young people ages 6 months to 24 years are among the groups most at risk of contracting the virus, along with pregnant women; people ages 25-64 with health issues; caregivers of children under 6 months; and emergency medical personnel and hospital workers.

The California Department of Public Health reported 31 new swine-flu deaths over the past week, bringing the statewide toll to 397. Last week the agency’s director, Dr. Mark Horton, said although it looked like nationwide the virus was on the wane, he believed a second wave was still “very likely.”

Dr. Jasjit Singh, a pediatric infectious disease specialist at Children’s Hospital of Orange County, says that overall admissions for H1N1 are declining at the hospital. She said the “vast majority” of those hospitalized have underlying conditions — predominantly cardiopulmonary or neurological disorders.

She agreed with Horton that another “upswing” of the virus could occur during the holidays. “There’s definitely the potential for another spike, especially as people travel and get together for family gatherings.”

The county is offering free doses for those in the high-risk groups at its clinic in Santa Ana (1725 W. 17th St.), Monday-Saturday, by appointment only. To schedule a visit, call 800-564-8448 Monday-Friday between 8 a.m. and 5 p.m.

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[adgal]

I hope this hasn't already been posted - seemed important:

http://www.examiner.com/examiner/x-29228-LA-Health-Technology-Examiner~y2009m12d6-Patient-in-Utah-has-swine-flu-virus-with-D225G-low-reactor-H1N1-mutation-causing-lung-hemorrhaging

Patient in Utah has swine flu virus with D225G, low reactor H1N1 mutation causing lung hemorrhaging
December 6, 6:11

A sample from a Utah swine flu patient has been analyzed, and shows the same H1N1 mutation found in Ukraine and other locations around the world. This mutation of the pandemic A H1N1 swine flu virus, the receptor binding domain change of D225G, is associated with lung hemorrhaging and resistance to the swine flu vaccine.

H1N1 mutation: D225G


The H1N1 mutation that affects the receptor binding domain D225G causes the swine flu virus to attach to cells deep in the lungs. This can cause severe illness, including lung hemorrhaging. The D225G RBD has been found in cases of swine flu in Ukraine, Brazil, and other locations around the world. Symptoms of bleeding in the lungs have been identified here in the United States.

It's possible that more cases exist, but the type of sample taken during testing may limit the number of cases identified. Swine flu samples are typically taken with a swab of the inside of the nasal passage, while the D225G strain would be found in lung tissue. The severity of H1N1 Influenza infections in Ukraine has been closely linked to the D225G RBD change, as well.

H275Y H1N1 influenza virus mutation

The H275Y H1N1 mutation causes the virus to be resistant to the antiviral medication Tamiflu. Currently, the H1N1 infections that are Tamiflu-resistant still respond to Relenza, another antiviral drug used to treat swine flu in the U.S. This mutation has been found in clusters in Maryland, North Carolina, and Wales, and in individual cases all over the world. In France, a combination of the H275Y mutation and the D225G mutation were found in a fatal case of the swine flu.

 

[Tom McDowell]

Swine Flu May Mean Seasonal Strain Won’t Emerge in U.S. Winter


By Tom Randall


Last Updated: December 17, 2009 00:00 EST

Dec. 17 (Bloomberg) -- Seasonal flu, which annually kills 30,000 Americans, may not appear in the U.S. for the first time in more than 40 years, crowded out by the swine flu pandemic and mass vaccination campaigns.

Seasonal strains are almost nonexistent in reports from countries where swine flu, or H1N1, has taken hold. In the U.S. and Europe, 99 percent of influenza cases tested last week were H1N1, according to government reports. Seasonal versions of virus that usually arrive in December and peak in February may not emerge at all, said Marc Lipsitch, a flu tracker at the Harvard School of Public Health, in Boston.

“I would bet against a seasonal flu this year,” said Lipsitch, a professor of epidemiology, in a telephone interview. “But I wouldn’t bet very much money.”

One of the seasonal strains most likely to appear this year, known as type B, was responsible for 7 of 478 positive cases in a testing sample for the week ended Dec. 5, according to the U.S. Centers for Disease Control and Prevention. A second form, H3N2, hasn’t been spotted at all.

Neither seasonal strain emerged after H1N1 struck in the Southern Hemisphere, where the winter flu season ended in September, according to the World Health Organization in Geneva.

Swine flu infection rates decreased in each of the last six weeks, the Atlanta-based CDC reported. That has spurred a debate among health officials on whether the H1N1 pandemic is grinding to a halt, and whether that strain will be replaced by a surge of seasonal cases as the Northern Hemisphere enters winter.

50 Million Infected

H1N1 infected 50 million people in the U.S. and killed an estimated 10,000 through Nov. 14 from the start of the pandemic in April, the CDC reported last week. About 90 percent of swine flu deaths were among people younger than 65.

With seasonal flu, the effects are reversed, with more than 90 percent of annual deaths among those ages 65 or older, according to the CDC.

Influenza is notoriously difficult to predict, said Thomas Frieden, the CDC director, in a Dec. 11 conference call. A dozen scientists surveyed by the CDC were split on the likelihood of a wave of new cases of either type of flu in January, when children return to school from winter recess.

Seven flu researchers surveyed by Bloomberg were similarly divided, though most agreed this year’s worst flu days are over. With each week that goes by without seasonal flu, the possibility of widespread outbreaks diminishes, said Arnold Monto, professor of epidemiology at University of Michigan, in Ann Arbor.

‘Nothing Yet’

“Two months ago, I would have said we’re going to see the seasonal viruses,” said Monto, who is also a member of the WHO’s emergency advisory committee. “But we haven’t seen anything yet, and we normally would have seen activity by now.”

Scientists aren’t sure exactly how some flu strains can crowd out others, said William Schaffner, chairman of the department of preventive medicine at Vanderbilt University in Nashville, Tennessee, and an outside adviser to the CDC on vaccine policy.

One theory involves the receptors where flu viruses attach themselves to lung cells. When a person catches the flu, the virus infects almost all of the exposed lung cells and occupies those receptors, Schaffner said in a Dec. 11 telephone interview. When a different virus comes along, it has nothing to attach to and is “crowded out,” he said.

The immune system also produces interferons, proteins that trigger protective defenses in response to an initial infection that can last for days after the first virus has cleared out.

Finding Hosts

When a pandemic strikes, and a new strain whips through a population with little natural immunity, so many people get sick simultaneously that a seasonal flu strain can’t find enough hosts with vacant receptors to spread, Schaffner said.

Crowding out occurred in the Southern Hemisphere, where swine flu struck at the same time that seasonal strains would normally be active, Schaffner said. In New Zealand, Australia, Chile and Argentina, once the pandemic took root, seasonal flu cases were almost nonexistent.

In Northern Hemisphere countries including the U.S. and U.K., swine flu struck months before the normal start of flu season. By January, most patients will have recovered, and their lungs may be ready for another bout of flu, Schaffner said in a telephone interview. Swine flu may be nearing its end and that seasonal flu may just be beginning, he said.

“I’m not so sure how strong the crowding out theory is,” Schaffner said. “It certainly seemed to play a role in the Southern Hemisphere, but we anticipate there will not be crowding out in January and February.”

Wall of Resistance

A wall of resistance against swine flu is expanding as people recover from the illness with newly acquired immunity, and as the country’s biggest-ever flu vaccination program expands to reach more people, said Ira Longini, of the University of Washington in Seattle. About 94.5 million doses of swine flu vaccine were available this week.

Minnetonka, Minnesota-based UnitedHealth Group Inc., the top U.S. insurer by revenue, isn’t budgeting for additional costs to treat H1N1 next year, Chief Financial Officer Mike Mikan said Dec. 1 at an investor conference in New York.

Flu viruses circulate in waves of infection with a sharp peak followed by declining rates. The first wave of swine flu cases came after the virus first emerged in April, according to CDC data. The second and larger peak started when pupils returned to schools in September and peaked in late October.

“My intuition tells me if we’re going to have a third peak it would have to be under conditions in which the virus spreads to older populations,” said Longini, a biostatician who advises the U.S. government on flu, said in a Nov. 24 interview.

‘Natural Immunity’

“You’d expect a combination of natural immunity and now vaccination would more or less eliminate the possibility of a big third wave in children,” Longini said.

Based on past pandemics and on what happened in the Southern Hemisphere, seasonal flu is also unlikely this year, Longini said.

Fear of pandemic swine flu heightened public vigilance in the U.S. against seasonal influenza, causing an early rush for vaccinations, beginning in September, and spot shortages around the country, according to the CDC. The country’s supply of seasonal flu vaccine is “nearing its end,” the CDC’s Frieden said.

The CDC doesn’t immediately track the number of people who are vaccinated for seasonal flu, Freiden said. A survey by Rand Corp., a nonprofit research group based in Santa Monica, California, found about a third of U.S. adults were vaccinated by mid-November, a rate similar to last year. About 17 percent said they still intend to get vaccinated.

Vaccine Suppliers

Vaccine suppliers Sanofi-Aventis SA of Paris, London-based AstraZeneca Plc and GlaxoSmithKline Plc, Basel, Switzerland- based Novartis AG, and CSL Ltd. of Australia are making 114 million seasonal-flu doses and 251 million swine flu doses for the U.S., according to the U.S. Health and Human Services Department.

Monto said he thinks there will be more swine flu cases in January, with outbreaks primarily in areas that the disease has so far skipped. The number of flu-related deaths this winter is likely to be smaller than normal, both Monto and Harvard’s Lipsitch said.

Since swine flu attacks children and young adults instead of the elderly, more years of life will be lost this year, and that is the true toll of a pandemic, said Lone Simonsen, research director in the department of global health at George Washington University, in Washington.

The “hallmark” of any new pandemic strain is that it targets young people, and that pattern is likely to continue with swine flu for 2 to 5 years, Simonsen said.

Hong Kong Flu

The last time seasonal flu strains were crowded out entirely in the U.S. was during the Hong Kong flu pandemic of 1968, Simonsen said. She predicted that swine flu will return in January and may circulate simultaneously with seasonal flu strains, potentially attacking both the young and old.

“It’s probably still a very good idea to get vaccinated, because this is not over,” Simonsen said in an interview on Dec. 8. “I don’t have a crystal ball, but we had two historical pandemics where there was an early fall wave -- 1918 and 1957 -- and both of those were followed by a winter wave.”

To contact the reporter on this story: Tom Randall in New York at trandall6@bloomberg.net

===


.

 

[Tom McDowell]

North Carolina

UNC student hospitalized with H1N1 dies
Updated at 07:16 AM today

http://abclocal.go.com/wtvd/story?section=news/local&id=7175470

http://www.timebomb2000.com/vb/showpost.php?p=3578619&postcount=7799

CHAPEL HILL (WTVD) -- Lillian Chason - the UNC student who's been battling severe swine flu complications in the hospital - has died.

UNC Hospitals officials told ABC11 Eyewitness News she passed away Wednesday.

Her father, Eric Chason, informed the public through a posting on Facebook around 10 p.m.

I'm sorry to have to tell everyone that Lillian died this afternoon at 5:20 PM. Her sat's kept dropping during the day and Dr Charles said that the ECMO machine could no longer keep her supported. As you all know, she put up an incredible fight and if there was anyway she could have overcome this disease, she would... have. We want to say thanks again to the wonderful people at the UNC hospital who have been and remain incredibly supportive. And thank you all for all your prayers and kind thoughts- it was an incredible comfort during this long difficult journey.

Lillian was an amazing young woman and we will miss her terribly.

Several thousand people have responded on Facebook, leaving their condolences and well wishes.


Chason was one of the rare people who suffered severe H1N1 complications even though she didn't have other medical problems and doctor's aren't sure why.

Chason had been in the hospital since November 20.

Her death comes a day after students at UNC held a blood drive to donate blood for the life support machine she was on.

Chason was on an ECMO (Extracorporeal Membrane Oxygenation) machine that oxygenated her blood and took the pressure off her lungs.

Anyone who'd like to send their condolences can go to her Facebook page.

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[Tom McDowell]

New Mexico

Deaths from H1N1 flu reach 47

Updated: Wednesday, 16 Dec 2009, 8:39 PM MST
Published : Wednesday, 16 Dec 2009, 8:39 PM MST

* Web Producer: Bill Diven

http://www.krqe.com/dpp/news/health/deaths-from-h1n1-flu-reach-47

SANTA FE (KRQE) - Four men with chronic health problems are the latest New Mexicans whose deaths have been linked to the H1N1 flu, the state Department of Health reported Wednesday.


NMDOH H1N1 Weekly Update: December 16, 2009

Influenza-Like Illness

Visits to health-care providers for influenza-like illness decreased from 4.5 percent last week to 3.3 percent this week. The Department tracks influenza-like illness, which is defined as fever and either cough and/or sore throat, at 26 clinics throughout the state. Influenza-like illness is the best indicator of flu activity in the state.

H1N1 influenza is still the predominant strain of flu in New Mexico at this time. All positive flu tests are presumed to be novel H1N1 influenza. The severity of illness due to novel H1N1 influenza has not changed nationally or in New Mexico from the spring.

Deaths

The Department of Health is reporting four new deaths in the last week in New Mexico for a total of 47. All patients had chronic medical conditions that put them at higher risk for flu complications. The cases were a 62-year-old male and an 89-year-old male both from Bernalillo County, an 85-year-old male from Doña Ana County and a 39-year-old male from Santa Fe County.

Disease investigation:

The overall rate of laboratory-confirmed influenza hospitalizations for New Mexico is 46 per 100,000 population. The county-specific rates range from 11.2 per 100,000 population for Torrance County to 150.1 per 100,000 population for Colfax County.

The overall rate of laboratory-confirmed influenza deaths for New Mexico is 2.3 per 100,000 population. The region-specific rates for the state range from 1.7 per 100,000 population for the Southwest to 3.1 per 100,000 population for the Southeast.

Laboratory-confirmed influenza deaths by region of residence
Reported since April 1, 2009

* Northwest: 9 deaths (2.0 per 100,000 population)
* Northeast: 6 deaths (2.0 per 100,000 population)
* Central: 17 deaths (2.6 per 100,000 population)
* Southeast: 9 deaths (3.1 per 100,000 population)
* Southwest: 7 deaths (1.7 per 100,000 population)
* Statewide: 47 deaths (2.3. per 100,000 population)

(2008 population estimates from the University of New Mexico Bureau of Business and Economic Research.)

Vaccine Information

The Department of Health has ordered about 554,300 doses of nasal and injectable H1N1 vaccine. Vaccine is arriving in small amounts and is being distributed to providers and public health offices statewide. Due to a change in the way vaccine is circulating in New Mexico, the Department can no longer accurately track how much vaccine each county has received.

The Department of Health expanded the high-risk priority groups last week, adding all children and young adults 6 months to 24 years. The Department encourages people in the following current H1N1 vaccination priority groups to get vaccinated as soon as possible:

* Pregnant women
* Household members/caretakers of infants younger than 6 months old
* Children and young adults 6 months to 24 years
* Adults 25 to 64 years of age with certain chronic health conditions that increase their risk of complications from influenza
* Health-care workers and emergency medical service personnel with direct patient care.


The Department of Health is encouraging people in the current priority group to call their primary healthcare providers first to ask if they are providing the novel H1N1 vaccine. People in the priority groups without insurance or a health-care provider, or whose provider will not offer the H1N1 vaccine, can get the vaccine from a local public health office.

Call your local public health office first to check the availability of H1N1 vaccine. Public health offices are listed in the phonebook’s blue pages under state government or online at www.nmhealth.org .

Hospitalizations by County

So far, there have been 957 hospitalizations related to novel H1N1 influenza this year. This week the Department of Health is reporting seven new hospitalizations.

The hospitalizations by county are as follows:

Bernalillo County (243), Catron County (2), Chaves County (16), Cibola County (12), Colfax County (22), Curry County (57), Doña Ana County (119), Eddy County (28), Grant County (20), Guadalupe County (1), Hidalgo County (2), Lea County (30), Lincoln County (6), Los Alamos County (4), Luna County (13), McKinley County (71), Mora County (1), Otero County (28), Quay (7), Rio Arriba County (20), Roosevelt County (9), San Juan County (61), San Miguel County (9), Sandoval County (41), Santa Fe County (47), Sierra County (10), Socorro County (16), Taos County (22), Torrance County (2), Union County (1), Valencia County (30) and 7 cases where residence has not yet been determined.

===


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[Tom McDowell]

New Mexico

Two North Jersey residents die of H1N1
Wednesday, December 16, 2009
BY BOB GROVES
The Record
STAFF WRITER

http://www.northjersey.com/news/121609_Two_North_Jersey_residents_die_of_H1N1.html

A 3-year-old Bergen County girl and a Morris County man were among four recent H1N1 flu deaths in New Jersey, officials said Wednesday.

The unidentified girl was hospitalized on Nov. 27 and died Nov. 29, state Health Commissioner Heather Howard said in a teleconference with reporters.

The Morris County man, 55, was hospitalized Nov. 26 and died Dec. 5, Howard said. Both patients had underlying health conditions, she said.

Two other deaths from flu were a 21-year-old Warren County man hospitalized on Nov. 19, and a 46-year-old man in Middlesex County, hospitalized on Nov. 24. The dates of deaths for these two patients have not yet been determined, she said. The Warren County man had underlying health conditions, the Middlesex County man did not.

There have been 38 H1N1 flu-related deaths in New Jersey this year — 20 since Sept. 1, and 18 during an outbreak in spring. However, most cases of the illness continue to be mild, Howard said. Nationally, flu activity declined during Nov. 29-Dec. 5, but flu-associated deaths increased, federal officials said.

Meanwhile, the state health department has told the nearly 1,400 vaccine providers in New Jersey to offer H1N1 flu shots to all who want it. The vaccine was previously restricted to at-risk target groups, including pregnant women, people six months to 24 years old, and adults with underlying health conditions.

Swine flu shots are now available to the general public because vaccine supplies in New Jersey have increased to 2.25 million doses from 1.4 million doses last month. Demand by target groups also had decreased at local and county levels, and federal officials recently recommended expanding the program.

Vaccine supplies are expected to increase through January, and there will be enough for all who want it, the federal Centers for Disease Control and Prevention said.

Pediatric H1N1 flu vaccine remains safe and effective, despite a “non-safety recall” by manufacturer Sanofi Pasteur this week of thousands of doses which were shown to have lost some strength, Howard said. Children do not need to be revaccinated, but those under 10 years old should get a second dose four weeks after the first one, she said.

For more information, visit the state health department web site at nj.gov/health, or call its H1N1 hotline at 1-866-321-9571.

E-mail: groves@northjersey.com


===


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[Tom McDowell]

Wisconsin

Swine flu deaths in Wisconsin rise to 47

Associated Press - December 16, 2009 1:35 PM ET

http://www.wkbt.com/Global/story.asp?S=11687301

MADISON, Wis. (AP) - Four more people have died in Wisconsin from the swine flu.

The state Department of Health Services reported Wednesday the death toll from the illness has risen to 47 people since April. The new deaths were reported in the last week in Bayfield, Dane, Milwaukee and Polk counties.

The department says the number of swine-flu related hospitalizations has also increased to 854 even though the number of overall cases is declining all over the state at the moment.

Public health officials say another wave of cases could be coming, and now is a good time to get vaccinated.

===


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[Tom McDowell]

Minnesota

Minnesota has six more swine flu deaths

Published December 16 2009

http://www.inforum.com/event/article/id/263020/

BLAINE, Minn. (AP) — Hundreds of people turned out for a mass swine flu clinic in Anoka County on Wednesday, the first day anyone in Minnesota could get vaccinated with the state Health Department's blessing.

By: Chris Williams, Assoicated Press Writer, Associated Press

BLAINE, Minn. (AP) — Hundreds of people turned out for a mass swine flu clinic in Anoka County on Wednesday, the first day anyone in Minnesota could get vaccinated with the state Health Department's blessing.

The clinic was scheduled to start at 1 p.m., but nurses started giving flu shots and squirting nasal mists to early arrivals nearly two hours before the official start. An official said 150 people had been vaccinated by 1:15 p.m. and about 500 by 3:30 p.m.

Many were like Bill Haugen, 31, of Andover, and Janet Lundeen, 64, of New Brighton who couldn't get the vaccine before Wednesday because they weren't in one of the priority groups designated by federal health officials.

Those groups included people younger the 25 years, pregnant women, health care workers, children and adults with certain underlying health conditions and those who care for infants. In Minnesota, that's an estimated 2.7 million people.

Haugen said he wanted to get vaccinated as quickly as possible because he was concerned about his children, ages 1 and 4. "I don't want to bring it home to my kids," he said at the clinic at the National Sports Center in Blaine.

Lundeen was there with her two grandchildren, ages 4 and 6, and their mother. "I want to stay healthy," Lundeen said. "I don't want to get the flu. I don't want to give it to my grandchildren or anyone else."

Another apparent benefit of making the vaccine available to all is that family members can prod each other into going out on a cold December day for a vaccination.

"We have to give each other support for these sorts of medical traumas," said Carol Beckerleg, 61, of Blaine, with a smile, as she waited for her daughter to arrive.

Also Wednesday, the Health Department reported that swine flu activity in the state remained low for the second week of December, although six new swine flu deaths were confirmed bringing the state's total to 50.

On Monday, the Health Department announced that clinics could open up vaccinations to anyone starting on Wednesday. The clinic put on by the Anoka County Community Health Department at the sports complex was the first in the metro area to take advantage of it.

Anoka County Community Health Department Director Rina McManus said she couldn't predict how the state's announcement would affect turnout at her clinic, but she said anything that gets more vaccine into the community was good.

"We want to get as much immunity in the community as possible," she said.

Many people are vaccinated at their doctor's offices instead of mass clinics, and spokesmen for HealthPartners Clinics and Park Nicollet Health Services both reported a spike in calls for vaccine appointments after the Health Department's announcement.

The chief of immunization at the Minnesota Department of Health, Kris Ehresmann, said the rising supply of vaccine in the state prompted the decision. "You reach some level of critical mass, and it's reasonable to open it up," she said.

The state has received about 1.5 million doses of the vaccine. That's not enough to vaccinate everyone in the priority groups, but the Health Department determined enough people in those groups had been given the chance to get vaccinated.

Minnesota was one of several states in the Upper Midwest that announced it would open its swine flu clinics in the past few days, including Iowa, Wisconsin, South Dakota and Illinois.

Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota, said opening the clinics was always expected when vaccine supply caught up to the demand from the priority groups.

"It's pretty much as planned," he said.

Flu viruses are notoriously unpredictable, but Osterholm said there's chance for a third wave of infections later this winter if enough people don't get their flu shots. "We need really desperately to get people vaccinated," he said.

The states announcements followed a Dec. 11 communication from the Centers for Disease Control and Prevention to state health officers. It reminded them that in the past month vaccine supplies had doubled while virus activity declined.

The letter from CDC Director Thomas Frieden said it was appropriate to open up the clinics in areas where the demand for vaccine from the priority groups had been met.

"In many communities," he wrote, "the goal of vaccinating as many people as want to be vaccinated can be best achieved by broadening the population able to access vaccine now."

Copyright 2009 The Associated Press.


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[Tom McDowell]

H1N1 Vaccine Recall Prompts Confusion

posted 5:57 pm Wed December 16, 2009 - VIENNA, Va.
from ABC 7 News -

http://www.wjla.com/news/stories/1209/688144.html

The recall of a type of swine flu vaccine has many parents concerned. While the vaccine remains safe, doctors say a batch of vaccine given to children is not as effective as it should be. But officials say parents don't have to do anything.

The manufacturer, Sanofi Pasteur, has recalled 800,000 doses nationwide, including 23,700 in Virginia, 10,300 in Maryland, and 1,200 in the District.

Sixty-four sites in Virginia received the now-recalled vaccine, including the Capital Area Pediatrics clinic in Vienna, where Kerry Drummond learned about the recall.

"I have three children and all three have gotten the shot," Drummond said.

She doesn't know if her kids got the recalled vaccine.

"It doesn't worry me as long as there's not going to be harm done to the children," Drummond said.

Doctors say it's an issue of effectiveness, not safety.

"Not a health risk at all," said Dr. Elizabeth Watts, the medical Director at Capital Area Pediatrics. "There are no negative effects from this vaccine or from this lot being recalled, at all."

The vaccine, which was shipped in a single-use syringe, is given to children 6- to 35-months-old. Each child was to receive two shots, a month apart.

Sanofi Pasteur says the potency of the affected doses dropped slightly -- 13-percent -- after the vaccine was shipped. But the vaccine maker added that studies have shown vaccines are still protective at only 50 percent effectiveness.

"It's still a mystery," a Sanofi Pasteur spokesperson told us. "We can't remember a flu vaccine ever losing potency. We won't supply any more until we fix whatever needs to be fixed."

Phones have been ringing off the hook at Pediatric Care of Rockville, which never even got the recalled vaccine. Seven-month-old Sophia Somerlock was getting her second H1N1 shot. Her dad's not worried:

"I'm an engineer so I know nothing is ever designed perfect, and I think drugs are the same way," Oscar Somerlock said.

The Centers for Disease Control and Prevention says children who got the recalled vaccine, do not need to re-do the shot; as long as they get the second booster shot, they are protected.

===


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[Tom McDowell]

Oklahoma

Three more in Oklahoma die from swine flu

By KIM ARCHER World Staff Writer
Published: 12/17/2009 10:21 AM
Last Modified: 12/17/2009 12:03 PM

http://www.tulsaworld.com/news/arti...articleid=20091217_17_0_hrimgs733904&allcom=1


Three more Oklahomans have died from swine flu in the state, bringing the total to 40 this year, according to the state health department.

Only 15 people in the state were hospitalized due to complications from the new H1N1 virus, down from 21 the previous week, the report said.

Local health officials are reminding the public it isn't too late to get a swine flu shot. They are offered free of charge at Tulsa Health Department's health clinics from 8 a.m. to 4 p.m. Mondays through Thursdays and 8 a.m. to 11 a.m. Fridays.

The clinics are:
# James O Goodwin Health Center, 5051 S. 129th East Ave.

# Central Regional Health Center, 315 S. Utica Ave.

# Expo Square Health Center, 4616 E. 15th St.

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[Tom McDowell]

Swine Flu Claims Four More Maine Lives
12/17/2009 11:30 AM ET

http://www.mpbn.net/News/MaineHeadlineNews/tabid/968/ctl/ViewItem/mid/3479/ItemId/10215/Default.aspx

All four victims, who were from Androscoggin, Kennebec, Knox and Oxford Counties, had serious underlying conditions, says Maine Center for Disease Control Director Dr. Dora Anne Mills.

Four more people died in Maine this week after contracting swine flu, state health officials say. The four were residents of Androscoggin, Kennebec, Knox and Oxford Counties, says Maine Center for Disease Control Director Dr. Dora Anne Mills.

Mills says all four had serious underlying health conditions, as did the other 13 Maine residents who have died after becoming sickened with the H1N1 virus.

Despite the bad news, Mills says the deaths are not unexpected. She says the ordinary seasonal flu claims about 150 lives in Maine each year. "Data indicate that H1N1 flu has been relatively mild in Maine compared with other states, and continues to decline," she says in a statement. "Hospitalizations due to H1N1 declined this past week from 50 a month ago to 11 and only one school reported an outbreak."

Moreover, Mills says the state now has much more H1N1 vaccine, which was in short supply for weeks. Earlier this week, state officials announced that they were expanding vaccine availability "beyond the US CDC's priority groups to include anyone who wants the vaccine, if local supplies allow," Mills says.

She says a federal recall of some of the vaccine is having little impact on Maine. She says the Maine CDC notified 25 practices on Wednesday that they had received some of the recalled lots of H1N1 vaccine. The remaining vaccine from these lots was pulled from their shelves.

She says 4,500 doses of the recalled lots had been recently shipped to Maine and that many of those had not been administered yet. Because there were no safety concerns and the vaccine was slightly weaker than the license standards called for, there are no recommendations for the children who received the vaccine except to proceed with their recommended second dose.

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[Perramas]

Rams call off practice after cases of swine flu are confirmed


ST. LOUIS -- The St. Louis Rams canceled practice Thursday due to an undisclosed number of swine flu cases on the team.

Coach Steve Spagnuolo would not say how many players had the illness but said five or six players had flulike symptoms, and some had had those symptoms for the last few weeks. He anticipated the Rams would return to practice on Friday.

"It's really more of a precaution than anything," Spagnuolo said. "We're checking everybody, we're just being careful."

Players were seen driving away from Rams Park shortly before noon after consulting with medical staff. Team spokesman Ted Crews said players received medication before leaving.

"If there was one (player), we'd have to be careful," Spagnuolo said. "I think it was the right thing to do."

Two players, quarterback Kyle Boller and center Jason Brown, missed practice Wednesday due to undisclosed illnesses. Spagnuolo said Brown was also ill on Monday, but had been expected to return to practice Thursday before the team decided to send players home.

Spagnuolo said the Rams became aware of the situation about 8:30 or 9 a.m., then held a team meeting after deciding on a course of action.

"There was no panic here," Spagnuolo said. "We took our time."

In early October, Texans rookie tight end Anthony Hill was hospitalized with swine flu in the first confirmed case in an NFL player this season. Other players around the league were also sidelined with flulike symptoms.

The nation's supply of swine flu vaccine is expected to reach 100 million doses this week, clearing the way for everyone to be protected, not just those considered at high risk. The 2009 H1N1 strain sickens younger people more frequently than the over-65 population who are seasonal flu's main victims.

Through mid-November, about one in six Americans have caught the new H1N1 flu, and about 10,000 have died, the Centers for Disease Control and Prevention said.

The new swine flu seems no more deadly than regular winter flu, which every year kills 36,000 Americans and hospitalizes 200,000.

Earlier this year, the NHL's Calgary Flames were criticized when players and their families received the swine flu vaccine while thousands of other people waited in lines that stretched for hours. Two Alberta Health Services employees were later fired.

British Columbia's provincial health officer also said last month that Vancouver Canucks also players jumped the line when they received vaccinations.

http://www.nfl.com/news/story?id=09000d5d8150968a&template=with-video-with-comments&confirm=true

 

[Caplock50]

I don't have the link, but an article I read says swine flu is really taking off over in China. And as I said when this flu virus was just getting started, "It likes warm weather". It's spring in china.

 

[summerthyme]

I don't have the link, but an article I read says swine flu is really taking off over in China. And as I said when this flu virus was just getting started, "It likes warm weather". It's spring in china.

Huh?

I didn't realize China was in the Southern Hemisphere...

You might want to check that, Cappy. Or did you mean Australia?

Summerthyme

 

[Caplock50]

well, the article said they were 'coming on to spring'. It's still spiking there, though...and China is the world's 'petri dish'.

 

[NWPhotog]

bttt

 

[Ben Sunday]

Another bttt for good measure.

 

[Tom McDowell]

OT - ?

UPDATE 1-Former CDC head lands vaccine job at Merck

(Adds details on Gardasil sales; Cervarix)

Stocks | Regulatory News

http://www.reuters.com/article/idUSN2124506920091221

WASHINGTON, Dec 21 (Reuters) - Dr. Julie Gerberding, former director of the U.S. Centers for Disease Control and Prevention, was named president of Merck & Co Inc's (MRK.N) vaccine division, the company said on Monday.

Gerberding, who led the CDC from 2002 to 2009 and stepped down when President Barack Obama took office, will head up the company's $5 billion global vaccine business that includes shots to prevent chickenpox, cervical cancer and pneumonia.

She had led CDC from one crisis to another, including the investigation into the anthrax attacks that killed five people in 2001, the H5N1 avian influenza, the global outbreak of severe acute respiratory syndrome, or SARS, and various outbreaks of food poisoning.

"As a preeminent authority in public health, infectious diseases and vaccines, Dr. Gerberding is the ideal choice to lead Merck's engagement with organizations around the world that share our commitment to the use of vaccines to prevent disease and save lives," Merck Chief Executive Officer Richard Clark said in a statement.

She may be charged with reigniting flagging sales of Merck's Gardasil vaccine to prevent cervical cancer by protecting against human papillomavirus or HPV. After an encouraging launch Gardasil sales have been falling and were down 22 percent in the third quarter at $311 million.

GlaxoSmithKline (GSK.L) (GSK.N) has won U.S. recommendations for its rival HPV vaccine, Cervarix and has been marketing the vaccine in the developing world.

(Reporting by Maggie Fox and Bill Berkrot; editing by Gunna Dickson)


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[Tom McDowell]

Authorities Turn Blind Eye as Swine Flu Spreads
By Wu Tong and Lu Fang
Sound of Hope Radio Network(SOH)

http://www.theepochtimes.com/n2/content/view/26713/


H1N1 Epidemic in China

Although a swine flu outbreak has recently killed a large number of pigs in southwest China, the local government has concealed the news. Moreover, diseased pigs are bought for low prices and sold at the farmer’s market, yet the government has turned a blind eye.

The outbreak occurred in Sichuan Province where farmers suffered greatly in last year’s earthquake. Many farmers say the loss of their livestock has brought them to a point of desperation.

Mr. He, a pig farmer from Pengzhou, told SOH that half of his 100 pigs developed cold symptoms and died within a few days.

"I called the Pengzhou City Livestock Bureau several times. They sent a few groups of experts here, but they couldn't find what was wrong with the pigs. I have spent over 3,000 yuan (US$439), but it hasn’t made any difference. This year our losses have been huge. I am on the brink of a mental breakdown. As farmers, we have little money. The death of the pigs has affected us deeply," Mr. He said.

Mr. Fang is a hog farmer. He said, "I had over 100 pigs, and I have lost almost half of them. They developed fever and died within a few days. The insurance company paid for 20 pigs. They couldn’t afford to pay more."

Another hog farmer from Pengzhou, also surnamed Fang, told SOH that the swine plague is serious in his area. “Many pigs have died, yet it hasn’t been reported by the media. The pigs sneeze, refuse to eat, and their ears turn red. The disease is air-borne and very contagious. It is like a pig plague.”

Read original Chinese article

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[Tom McDowell]

India

H1N1 virus may combine with seasonal flu'
Umesh Isalkar, TNN 20 December 2009, 06:14am IST

PUNE: A simultaneous influenza activity of both the novel strain of the H1N1 and the seasonal influenza virus is being seen circulating in the country, which is a cause of serious concern, said A C Mishra, director of the National Institute of Virology (NIV) here on Saturday.

Scientists at the NIV are keeping a close watch because the H1N1 virus may come together with the seasonal influenza and lead to easier spread of the virus in the community, he said.

Mishra was speaking as a guest of honour at the inaugural session of the 18th annual conference organised by the Pune Obstetrics and Gynaecological Society (POGS) at the IMA house in the city on Saturday.

"In western countries, all influenza cases are turning out to be that of H1N1 flu, while in India, we see cases of seasonal as well as swine flu infection. Hence, we cannot predict with accuracy whether the virus will behave the way it is behaving now. There is too much uncertainty. There are definitely reasons to worry; there are reasons to be more alert and cautious as well," Mishra said.

Similarly, the NIV will also keep a close eye on the outbreak of any influenza in the country to keep constantly ruling out the local transmission of the virus. "A sudden rise in any influenza will be immediately taken into account. We will even be conducting tests on a few samples to find out whether the virus has mixed up with common influenza virus," said Mishra.

Elaborating further, Mishra said, "The scientific understanding of the H1N1 virus is changing every day. What we think of today change the next day."

Taking stock of the slight rise in infection cases in the last two weeks, Mishra said, "A slight upward movement is being seen in the swine flu infection in the last few days. Similarly, a slight rise in the deaths caused by the infection is also seen in the last few days. We are still at the high risk zone in Pune. There is a definite need to be wary and take precautions."

He added: "At this stage, it is important to maintain surveillance and update pandemic preparedness and response plans accordingly."

On this occasion, the POGS's awareness posters on swine flu and pregnancy was also released. Vikas Amte of Anandvan graced the occasion.

Infertility expert Sanjeev Khurd spoke about various social initiatives of the POGS. "Members of the POGS have always been on the forefront to render medical services in the time of crisis. The POGS will continue to fulfil its social obligation in the days to come," Khurd said.

As part of the scientific programme, genetic medicine expert Prakash Gambhir and Vrushali Joshi made presentations on the various aspects of genetic disorders as well as genetic screening.


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[Tom McDowell]

Experts say pandemic could have a silver lining if it knocks out other viruses

By Helen Branswell Medical Reporter (CP) – 22 hours ago

http://www.google.com/hostednews/canadianpress/article/ALeqM5gZMcuOPsQb-L-xZQIp3j0__PwNSQ

TORONTO — When you think of a flu pandemic, the images that come to mind are of people sick and people dying.

But influenza experts quietly admit there may be a silver lining - or several - to the H1N1 pandemic that erupted this year. Not just in the event itself, which was milder than feared, but also in the viral legacy it may leave.

In the wake of this pandemic, flu vaccine could be easier to make or could cover more targets. A tricky problem of drug resistance could disappear. And the toll influenza takes on the elderly could conceivably ease, at least for awhile.

Before going too far down What-If Road, however, it's important to note that predicting influenza's path is a mug's game. The longer people study it, the less likely they are to try to guess what influenza viruses may do.

"I don't know - right now everything's a possibility as far as I'm concerned," Dr. Michael Osterholm, director of the University of Minnesota's Center for Infectious Diseases Research and Policy, cautions when asked about what the flu landscape might look like in the aftermath of this pandemic.

Still, even experts who share that understanding are thinking about some possibilities.

Their optimism is in large part fuelled by a phenomenon known as viral replacement which has been seen in previous pandemics, or at least the three that have been studied using modern laboratory techniques. In simple terms, during the pandemics of the 20th century - 1918, 1957 and 1968 - the new virus snuffed out its viral predecessor.

If the same thing occurs as a result of the pandemic of 2009, the world might actually one day look back fondly on the swine flu virus that caught us all by surprise last spring, some suggest.

"If this pandemic virus were to replace seasonal strains, either H3(N2) or H1(N1), that may be a blessing in disguise," says Dr. Danuta Skowronski, an influenza epidemiologist at the British Columbia Centre for Disease Control.

To grasp the significance of what might be afoot, it's helpful to have some flu basics.

Influenza viruses are divided into three large families, A, B and C, though C viruses are thought to bit players when it comes to human illness.

Pandemics can only be triggered by influenza A viruses. And historically there was only ever one subtype of influenza A around at a time. But that changed in 1977 when H1N1 viruses, which had stopped circulating 11 years earlier, mysteriously re-emerged. (It is widely believed the virus "escaped" from a Russian lab as a result of a research accident.)

Since then, there have been two flu A viruses circulating, seasonal H1N1 and H3N2. Annual flu shots target both A viruses plus one of two families of influenza B viruses.

Influenza B causes a fair amount of human illness. And earlier this year there was some debate about making a four-component or quadrivalent vaccine to include both B families. But there has been hesitancy because making the trivalent vaccine every year is challenging enough.

If the pandemic H1N1 gets rid of both H3N2 and seasonal H1N1, vaccine manufacturers would only need to include one influenza A component - the 2009 H1N1 - in seasonal flu shots.

They could make a bivalent - two component - vaccine, which would be easier to produce. Or they could stick with a trivalent shot, but have it cover one A and both Bs, making the shot more protective.

Getting rid of both of the previous seasonal A viruses also appeals from another point of view. H3N2 is a nasty virus, one which takes a heavy toll on the elderly. No one in public health would miss H3N2 if it disappeared.

"It would be the most amazing thing," says Dr. Allison McGeer, a flu expert at Toronto's Mount Sinai Hospital.

"Because a the great majority of nursing home outbreaks are (caused by) H3N2. You get rid of 80 per cent of influenza outbreaks in nursing homes - (it would) be brilliant."

Dr. Anthony Mounts, a flu expert with the World Health Organization, says since this pandemic started people have gone back and studied the patterns of H1N1 and H3N2 seasons. When H1N1 viruses predominate, younger people are generally hit harder; during H3N2 seasons, as McGeer observes, the worst of the illness occurs in the elderly.

"Why that is, I don't think anybody really understands," he says.

But children and adults respond better to flu vaccine than do seniors, whose immune systems are breaking down with age. So if the burden of influenza shifts down the age spectrum, the primary tool available to fight it - vaccine - could be targeted to people who get more benefit from it.

And younger people are less likely to die of flu than seniors, in whom a bout of flu can be the proverbial final straw.

"That might be actually the silver lining, is that this is something that's less deadly than H3 and maybe something that we can do more about," says Mounts, who, like Osterholm, is quick to warn "it's all conjecture at this point."

The WHO's top flu expert injects a note of caution of his own.

Dr. Keiji Fukuda points out the pandemic caused by H3N2 was the mildest of the three in the last century. Its behaviour as a pandemic virus did not foreshadow what was to come.

"Do we know that this H1N1 virus is going to always be like it is now? The chances are: Probably not," Fukuda says.

"I mean, it could stay mild all the time, but I think the lessons from H3N2 is that something which starts out and looks relatively mild in fact can become something which becomes more severe over time."

As it is, many flu experts think we may be stuck with H3N2 for awhile yet. They are not convinced the pandemic virus can oust it as well as seasonal H1N1.

Dr. Arnold Monto, of the University of Michigan, notes H3N2 viruses are still circulating in pockets of Southeast Asia and in the tropics. He won't venture to guess whether they will die out there too, or if those regions will serve as a reservoir for resurgent H3N2 activity.

"Flu is un-pre-dict-able," he says, stringing out the word for emphasis.

Dr. Nancy Cox isn't convinced H3N2 is going away. But the head of the influenza division of the U.S. Centers for Disease Control would be happy with a one-for-one exchange, with the pandemic H1N1 replacing the seasonal virus of the same name.

That's because seasonal H1N1 viruses are resistant to oseltamivir (Tamiflu), the main drug used to fight flu.

The pandemic H1N1 viruses are susceptible to Tamiflu, though they are resistant to two older flu drugs, amantadine and rimantadine. Those two drugs aren't widely used anymore because resistance to them develops easily.

Swapping viruses that are immune to Tamiflu for ones the drug works against would be a bargain, Cox suggests. "Getting rid of resistance in circulating H1N1 viruses would be a real silver lining."

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Via Rhiza forum and as noted there - the fly in the ointment is highlighted above.

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[BlueNewton]

Interesting post just above, Tom. Not sure I agree with that logic, though. I can't see gedtting excited that the seasonal flu wouldn't be killing some seniors in nursing homes when the trade off is swine flu killing off babies, pregnant women, and kids.

"Because a the great majority of nursing home outbreaks are (caused by) H3N2. You get rid of 80 per cent of influenza outbreaks in nursing homes - (it would) be brilliant."