Global's Daily Pandemic (H1N1) 2009 Update - July 14, 2009

GMS Pandemic (H1N1) 2009 Update as of July 14th, 2009

(0830 HRS PST)
The next update will be on Thursday July 16th, at 08:30 PST.

The WHO Pandemic Alert level remains at Phase 6

PLEASE NOTE: The World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organization for Animal Health (OIE) have decided to use "Pandemic (H1N1) 2009" for the name of the novel influenza virus currently circulating globally.

• On July 6th, the World Health Organization released its latest case count for novel Pandemic (H1N1) 2009 influenza worldwide: 94,512 cases and 429 deaths in over 100 countries, up 4,591 cases and 47 deaths from July 3rd.. WHO

Local/National News

• On July 10th, the Public Health Agency of Canada (PHAC) announced that the number of confirmed cases of Pandemic (H1N1) 2009 influenza since July 8th has risen to 9,714 from 9,429 . Of the Canadian cases thus far, 894 required hospitalization and 39 deaths have occurred. PHAC


• The death of a 25-year-old Calgary mother from the H1N1 virus has left her family reeling and wondering how the otherwise-healthy young woman could have been struck down by the flu so suddenly. Vanessa Bluebell died in hospital early Thursday just days after being admitted, leaving behind four sons ages 1, 3, 4 and 7. National Post

• Health authorities in Canada and the United States are on high alert for Internet scams related to pandemic flu and are cracking down on websites that are selling unauthorized products and making illegal claims about how to prevent and treat the illness. Among the products that have popped up online are:




• A pill that is purported to cure flu infection within hours


• A spray that claimed to leave a layer of ionic silver on the skin that would kill the virus


• Wall-mounted ultraviolet light machines that allegedly prevent the spread and destroy the virus


• An electronic instrument that declared its "photobionic energy" and "deeply penetrating mega-frequency life-force energy waves" would strengthen the immune system and prevent infection Canwest

International News

• An outbreak of pandemic H1N1 flu at California’s San Quentin State Prison led officials to limit the acceptance of new inmates and halt the transfer of prisoners to other correctional facilities. Nearly half the prison’s 5,153 inmates have been placed under quarantine after 47 exhibited flu-like symptoms. LA Times


• US influenza activity decreased in early July but stayed above normal for this time of year, the CDC said in its weekly flu surveillance report today. More than 97% of the influenza A viruses that were subtyped were the Pandemic H1N1 virus. Nine states still reported widespread flu activity, while 10 states and Puerto Rico reported regional activity. Five pandemic H1N1-related pediatric deaths were reported. The proportion of medical outpatient visits due to flu-like illness was below the national baseline. CDC flu report


• The US tally of pandemic H1N1 flu cases has risen to 37,246, with 211 deaths, the CDC reported on Friday. The numbers are up by 3,344 cases and 41 deaths since the last CDC report on Jul 2. Wisconsin led the list with 6,031 cases and 4 deaths, followed by Texas (4,463 and 21), Illinois (3,259 and 14), New York (2,582 and 52), and California (2,461 and 31). CDC

Vaccine News

• H1N1 Pandemic flu vaccine production has hit a snag, with manufacturers reporting a disappointingly low yield when vaccines viruses are grown in eggs. The World Health Organization says so far the yield for egg-based production is half or less what manufacturers get when they make vaccine to protect against seasonal H1N1 viruses. If the yield cannot be increased, it will slow the rate at which pandemic vaccine comes out of the production pipeline, adding to the time it takes to protect populations. AP


• The WHO’s Strategic Advisory Group of Experts (SAGE) recently met and recommended that all countries should immunize their health-care workers as a first priority to protect the essential health infrastructure. Moreover, Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research, said that that “The committee recognized that the H1N1 pandemic ... is unstoppable and therefore that all countries need access to vaccine." WHO


• The United States will order another $1 billion worth of pandemic H1N1 influenza vaccine, Health and Human Services (HHS) Secretary Kathleen Sebelius. "There'll be another $1 billion worth of orders placed to get the bulk ingredients for an H1N1 vaccination," Sebelius told CNN, without naming the suppliers. Sebelius had announced on May 22 that HHS would spend about $1 billion to buy vaccine antigen and adjuvant and fund clinical studies. Reuters story


• The US federal government expects to mount an H1N1 vaccination campaign this fall, initially targeting schoolchildren, adults with health problems, pregnant women, and healthcare and emergency workers, a top US official said late last week. “"While we have made no final decisions about its scope, and have 'off ramps' built into our decision making process if the circumstances change, at this point, we expect to initiate a voluntary fall vaccination program against the 2009 H1N1 flu virus," said Health and Human Services (HHS) Secretary Kathleen Sebelius. CIDRAP


• Australia-based flu vaccine maker CSL Ltd said on Monday that it expects to launch a human trial of its novel H1N1 vaccine on July 22nd. In a press release, CSL said it would undertake the trial with a research group in Adelaide and was seeking healthy adults aged 18 to 64 to enroll in the study to compare two injections of a standard dose, administered 3 weeks apart, with a higher dosage. The Australian government has ordered enough vaccine to immunize 10 million people. Bloomberg News

Guidance and Recommendations

• Canadian Health Minister Leona Aglukkaq and Chief Public Health Officer Dr. David Butler-Jones recently released guidelines for health professionals on caring for pregnant women with H1N1 flu virus. "Thankfully the majority of H1N1 illness in Canada is mild, but we are seeing that some people, including pregnant women, are more susceptible to serious illness and complications," said Minister Aglukkaq. "To help protect mothers and their babies, experts at the Public Health Agency of Canada have worked with their provincial and territorial partners to develop clinical care guidelines that will help healthcare professionals treat pregnant women more effectively." PHAC


• The Centers for Disease Control and Prevention (CDC) recently updated its guidance on caring for people who are sick with pandemic H1N1 flu at home. The revision incorporates interim guidance on facemask and respirator use that the CDC updated in late May. The updated home care guidance suggests that all caregivers, not just those in high-risk groups, who must have close contact with a sick person try to use a facemask or N-95 disposable respirator. CDC home care guidance

Today’s Key Question

When does the World Health Organization (WHO) expect the Pandemic H1N1 Flu vaccine to become available?

According to the WHO, it may be several months until a fully-licensed pandemic H1N1 flu vaccine is available to the public.

The pandemic H1N1 flu viruses currently being used to develop a vaccine are only producing about half as much of the required "yield" as do regular flu viruses, and WHO has asked its laboratory network to produce a new set of viruses as soon as possible. According to Marie-Paule Kieny, director of the WHO’s initiative for Vaccine Research, a lower-producing vaccine could significantly delay the timelines for vaccines which would in turn delay many Western countries’ plans to begin public vaccination campaigns in the fall.

Moreover, before countries can start any mass swine flu vaccination campaigns, the vaccines need to be vetted by regulatory authorities for safety issues. That means testing the vaccines in a small number of humans first, which can take weeks or months. "I think it will be a very significant challenge to have vaccines going into peoples' arms in any meaningful number by September," said Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota.

There is also still the question of who will get the first doses of vaccine once they become available. According to Kieny, many of those questions remain unanswered at the moment; however, she said the WHO's vaccine advisory group recommended that health care workers receive the first Pandemic H1N1 flu shots since they are on the front lines of the global outbreak. Furthermore, the WHO’s vaccine experts have recommended that countries decide which groups – such as pregnant women, or people with chronic respiratory problems – should get the vaccine first.

In addition, several drugmakers are considering the use of adjuvants, ingredients which can stretch a vaccine's active ingredient, allowing for many more vaccine doses. However, data is limited on the safety of vaccines with adjuvants in populations including children and pregnant women, and in the U.S., there are no licensed flu vaccines that use adjuvants. Associated Press.