Global's H1N1 Breaking News Update

The next Update will be November 3rd @ 0830 hrs (PST)

Breaking Vaccine News

Due to GlaxoSmithKline (GSK) temporarily interrupting production of Canada’s H1N1 vaccine to make a version without the adjuvant for pregnant women, severe vaccine shortages have occurred across Canada. GSK has switched its one production line back to making the adjuvanted vaccine, but it will take some time to ramp up to the target of producing three million doses per week. In the first week of November, only about 400,000 doses will be shipped out as well as 225,000 doses of the adjuvant-free vaccine. A WHO advisory group said that one dose of the vaccine is enough to produce a good immune response in anyone over six months, while the immune-boosting adjuvant that is added to shots in Canada and elsewhere has proven safe for pregnant women. National Post

• Ontario is suspending the rollout of its H1N1 flu shots to the general public next week, amid a shortage of the vaccine. Only those at higher risk of developing complications from the virus will be vaccinated. CBC

• In Nova Scotia, doctors' offices won't receive any vaccine until further notice. Chronicle Herald

• Manitoba will only receive 15,000 doses of the H1N1 flu vaccine next week and could run out by Tuesday, November 3rd. Winnipeg Free Press

• Saskatchewan, BC, Alberta, Newfoundland and Labrador, New Brunswick and Quebec will also limit H1N1 vaccination to only those in the high priority groups in order not to run out. CBC

Global's H1N1 Update - 10/29/09

The next update will be on Tuesday, November 3rd, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 18th, 2009

National News

The Public Health Agency of Canada has released new infection control guidelines for passengers of planes, trains, ferries and intercity buses. The guidelines include advice on how to deal with sick passengers and crew, availability of hand-washing for passengers and regular cleaning of public areas in stations and vehicles. Since April, there have been 1,600 hospitalizations for H1N1 infections in Canada, including 300 people admitted to intensive care units. Health Minister Leona Aglukkaq suggested Canadians who feel ill should defer their travel plans until they're better. The federal government encouraged travel companies to easily allow Canadians to rebook if they are ill.CBC

International News

Hospitals in the United States are experiencing waves of flu patients arriving at their doors, doubling their emergency room volume and putting pressure on intensive care units. If the numbers continue to rise, some doctors predict such an influx of intensive care patients eventually could force some hospitals to cancel services such as elective surgery. Thomas Frieden, director of the Centers for Disease Control and Prevention, reported Friday that H1N1, has killed more than 1,000 people nationwide and prompted 20,000 to be hospitalized. One scenario by the President's Council of Advisors on Science and Technology forecasts that if 30% of the U.S. population contracts H1N1 flu, 90 million could get sick, 1.8 million would be hospitalized and 30,000 or more would die. USA Today

The top public health official in Los Angeles County stood at an H1N1 vaccination site in Compton, Calif. and gently told elderly residents that they really ought to go home. People have lined up in Southern California and across the country in recent days in the hope of getting a prick in the arm, but a dearth of the H1N1 vaccine has created an unexpected dynamic: local government officials, hospital workers and doctors in private practice are being conscripted as 'ad hoc swine flu police'. The goal is to make sure that those Americans with the highest risk for contracting the virus — and experiencing the more dangerous complications that can ensue — get injected first. New York Times

English soccer players were warned Tuesday that spitting could increase the risk of catching H1N1 as Bolton joined Premier League rivals Blackburn in saying squad members had contracted the virus. England's Health Protection Agency said the "disgusting" habit -- a common sight at soccer matches -- could see the infection passed on". Bolton manager Gary Megson said Tuesday several players were suffering with H1N1 flu. His comments came a day after Blackburn boss Sam Allardyce said the virus had struck at his club. Vancouver Sun

Gennady Onishchenko, chief sanitary office of Russia, confirmed 1,819 cases of the H1N1 virus with four deaths. Onishchenko said the cases began growing considerably in October, traditionally the time for a seasonal flu outbreak. He said Russia's worst-hit regions are in the Far East and east Siberia bordering on Mongolia and China. Russia plans to start an H1N1 vaccination program in December. Ten million people - medical staff, employees at electric power and water treatment plants and other facilities - will be initially inoculated against the flu. Another 30 million will be vaccinated if the virus spreads. Ria Novosti

Antiviral News

Work in the British Medical Journal shows Tamiflu and Relenza rarely prevent complications in children with seasonal flu, yet carry side effects. Although they did not test this in the current H1N1 pandemic, the authors say these drugs are unlikely to help children who catch the virus. While the latest study shows that antivirals can shorten the duration of normal seasonal flu in children by up to a day and a half, it also shows that the drugs can cause unpleasant side effects, such as vomiting with Tamiflu. There is also the risk that widespread use of the drugs will mean the virus will develop resistance to them. BBC

Vaccine News

Production yields for H1N1 swine flu vaccine are now increasing and output should reach full throttle in around a month's time according to the chief executive of GlaxoSmithKline, Andrew Witty. Major vaccine producers have been struggling with low yields, leading to lower than expected shipments and a scramble for supplies in some markets -- notably the United States. Worldwide, Glaxo has taken orders for more than 440 million doses of Pandemrix, its adjuvant containing H1N1 vaccine. BBC

Provinces in Canada are scrambling to accelerate their H1N1 vaccination programs and some hospitals are redirecting doctors from clinics to emergency rooms as the second wave of the pandemic virus grips the country. Toronto Public Health said it will fast-track its vaccination clinics for high-risk groups, and make the vaccine available on October 28th rather than next week. Alberta, meanwhile, will open 11 new clinics to meet public demand for the vaccine. With doses slowly rolling in from GlaxoSmithKline, Canada's vaccine supplier, jurisdictions have opted for a phased-in approach: First in line are health-care workers and groups that are more likely to develop complications, such as adults with chronic health conditions, young children, pregnant women and those living in remote communities. Healthy Canadians are being asked to hold off, until priority groups receive their shots. Globe and Mail

Some Ontario residents at high risk of complications from H1N1 are unable to get the vaccine because they are allergic to eggs. Eggs are used as incubators for the H1N1 vaccine, so those with egg allergies have been advised to only get vaccinated under the supervision of their allergists. However, so far the vaccine is not available to Ontario allergists. Allergists can determine what precautions must be taken for each patient depending on medical history. They can use methods to help desensitize some patients to the vaccine if necessary. They are also trained to recognize and treat any dangerous adverse reactions that might occur. CBC

With Canadians clamouring for the H1N1 vaccine, several public health authorities have cancelled or deferred programs in order to focus on flu vaccination. Earlier this month, two Saskatchewan health units said they were temporarily cutting programs such as breastfeeding support centres, prenatal classes, travel health clinics and parenting support groups. Public health services in other provinces have also cut back some programs. In Newfoundland and Labrador, the Eastern Regional Health Authority said it was suspending several campaigns. Health education in schools, such as physical fitness and smoking-cessation campaigns, are delayed. A dental program in low-income schools has been set back. IFP Press

Weekly Feature

Get all the H1N1 virus infection rates, vaccine schedules, and antiviral availability in Canada on the Public Health Agency of Canada’s interactive nation-wide map. PHAC

Global's H1N1 Update - 10/27/09

The next update will be on Thursday, October 29th, at 0830 hrs PST.
The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 18th, 2009

National News

A pre-teen girl believed to have had the H1N1 virus, but no pre-existing medical conditions, has died on October, 24th at an Ottawa hospital. The girl was initially admitted to hospital with mild symptoms, but her condition quickly worsened. Dr. Paul Roumeliotis, the medical officer of health for the Eastern Ontario Health Unit, said the girl was healthy until the appearance of the flu symptoms, which included fever, muscle pain, and coughing. The virus has now contributed to at least 87 deaths in Canada. Edmonton Sun

Officials say 15 schools in Edmonton have an absentee rate above 10 per cent, while 30 per cent of the students at one school called in sick. Letters have been sent home with students in the school reminding them to take precautions, like washing their hands frequently. The letter also had a warning for students and parents who may be in high risk groups to pay special attention to any of the indicators of influenza infection and see a health-care provider immediately. CBC

Health Canada recently issued a reminder to pharmacists and health care providers on how to properly transform capsules of the antiviral drug Tamiflu into a liquid form suitable for children. Some pharmacists have been using the capsules because of a shortage in some areas of the country of the syrup form of Tamiflu. The maker of Tamiflu, Hoffman-La Roche, said it is placing a higher priority on producing the capsules given increasing demand during the current pandemic of H1N1 influenza A virus. Health Canada's reminder includes instructions on how to mix the powder from the capsules with syrup for use by children. CBC

International News

In North America, the U.S.A. is still reporting nationwide high rates of pandemic H1N1 2009 virus detections well above baseline rates. Although influenza activity is low in most countries in Europe, in Belgium, Israel, the Netherlands, Norway, and parts of the United Kingdom consultation rates are above baseline levels. Of note, the proportion of cases in Asia that are related to seasonal influenza A(H3N2) continue to decline globally as the proportion related to pandemic H1N1 2009 virus increases. Currently, only East Asia is reporting any significant numbers of seasonal influenza isolates. In tropical areas of the world, rates of illness are generally declining, with a few exceptions. WHO

Responding to a dramatic surge in the number of U.S. H1N1 cases, President Barack Obama has signed a proclamation declaring H1N1 influenza a national emergency in the United States. The order will speed the ability of hospitals and health authorities to take measures to fight the pandemic through such steps as setting up tents in hospital parking lots to establish extra emergency room care and creating health clinics in school gymnasiums or community centres. The death toll in the U.S. since the end of August of laboratory-confirmed cases of H1N1 is 411, but a factor worrying health experts is that many of the victims are young children. Globe and Mail

Rhode Island is now the first state in the US to launch a system for tracking H1N1 and other disease outbreaks. The Department of Health will use”e-prescribing” to track diseases. The system was first created to issue drug prescriptions electronically. Another first that made this tracking possible; Rhode Island is the first state with 100 percent of its retail pharmacies participating in ‘e-prescribing’. WPRI

South Korean health authorities have reported the deaths of three children due to H1N1, raising the country's death toll from the new virus to 23. According to the Ministry for Health, Welfare and Family Affairs, a nine-year-old boy, an 11-year-old girl and a 15-year old middle school student infected with H1N1 succumbed to their illness. Fears are growing in South Korea recently over the fast spread of the new flu. The government is considering setting up a government-wide national emergency management agency to cope with the H1N1 virus. China View

Vaccine News

The H1N1 influenza vaccine is now available across most of Canada to health care workers and people considered at a higher risk for complications from the respiratory illness. Eligible groups include individuals under the age of 65 who have chronic medical conditions, as well as pregnant women, children under the age of five and people living in First Nations or remote and isolated communities. Clinical trials worldwide suggest that up to 85 per cent of healthy adults who are vaccinated will develop immunity within 10 days. Vaccinations are expected to continue throughout November and December and are free of charge. CBC

Questions about the tardy US supply of pandemic H1N1 vaccine have increased with the report that most of Novartis's doses may not reach the country until early in 2010 and a European regulatory recommendation that may have implications for the global vaccine supply. Novartis has a contract to supply about 35% of the total projected US supply of about 251 million doses. Only 16.1 million doses have become available. The European Union's drug regulatory agency announced it would maintain an earlier recommendation for a two-dose regimen of the three H1N1 vaccines approved in the EU, despite data showing one-dose efficacy for two of the vaccines. The recommendation raises the possibility of a major increase in European demand for the vaccines, with possible repercussions for the US supply. CIDRAP

In one of Canada's first sweeps of H1N1 inoculation, street nurses will be on Vancouver's Downtown Eastside, vaccinating the homeless, the downtrodden, and the drug-addicted. On the other side of the country, H1N1 syringes will be administered to individuals at some of the bigger shelters in Montreal and Toronto. Many of those who work closely with the homeless hope the efforts will be enough to keep H1N1 from striking a population segment that is among society's most vulnerable. CTV

The federal government has bought 200,000 doses of unadjuvanted vaccine from an Australian company so that pregnant women who want to use that version of the shot can get it earlier. The doses are expected to arrive early next week. The government has ordered 1.8 million doses of the unadjuvanted H1N1 vaccine from GlaxoSmithKline but they are not expected to arrive until after non-priority groups begin getting shots in the arm. The doses being administered contain an adjuvant, a mixture of water, fish oil, and vitamin E that stretches the supply of vaccine so it does not have to contain as much antigen. Ottawa Star

Weekly Feature

Get all the H1N1 virus infection rates, vaccine schedules, and antiviral availability in Canada on the Public Health Agency of Canada’s interactive nation-wide map. PHAC

Global's H1N1 Update - 10/22/09

The next update will be on Tuesday, October 27th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 11th, 2009

Vaccine News

Canada's health regulator has approved the country's H1N1 influenza vaccine. Canada has ordered 50 million doses from GlaxoSmithKline that are being produced at the company's Ste-Foy, Que., plant. The federal government has already shipped more than two million doses of the vaccine across the country which could be available as soon as Monday. Health Minister Leona Agglukkaq has also approved the rapid rollout of the vaccine. Vaccinations in most provinces should begin by October, 26^th. CBC

British Columbia's provincial health officer, Dr. Perry Kendall, said the province is looking into bringing in retired nurses or pharmacists licensed to deliver injections to help with the H1N1 vaccination process. In Toronto, mass flu clinics will be set up in civic centres and schools. In Winnipeg, an empty store in a downtown mall will be converted to a vaccination centre. Health care workers in Toronto and Saskatchewan are set to receive the first doses while in New Brunswick, some of the first vaccination clinics will take place within the province's First Nations communities, as well as schools. Mass vaccination clinics for H1N1 will also be held in places like community centres and school gymnasiums. AOL

Saskatchewan has unveiled its provincial H1N1 vaccination program where vaccinations begin with health-care workers, moving into the risk groups of those with underlying health conditions, young children, and pregnant women. About 120,000 people are in the high-risk categories, including First Nations and those in remote communities. People will be asked to complete a questionnaire when they go to an immunization clinic to determine if they are in a high-risk group. Canadian Press

European governments are starting to roll out mass vaccination programmes against the H1N1 virus. A nationwide vaccination program launched on Oct. 21 in Britain, starting with front-line health workers and hospital patients deemed to be at high risk. Vaccinations for health care workers in France began on October 20^th. Vaccination programs began on October 12^th and 14^th in Sweden and Italy respectively, while the program should start on 22^nd October in Finland, 26^th October in Germany, November 2^nd in Ireland, and November 9^th in Switzerland and the Netherlands. Reuters

According to Dr. Anne Schuchat, officials at the federal Centers for Disease Control and Prevention had expected about 40 million doses of the H1N1 flu vaccine to be distributed by the end of the month, but it looks as though a maximum of 28 million to 30 million doses will actually be shipped in the same time frame. Mexico is facing similar shortages of the H1N1 vaccine. Officials had promised 30 million doses, but now say they don't expect the first batch of 5 million to 8 million doses until late December. The delay was attributed to the huge demand for vaccines around the world. Los Angeles Times

H1N1 influenza vaccinations will begin in New York City’s public elementary schools next week, as parents are encouraged to sign consent forms being sent home with students now. The vaccinations will be given by school nurses and are expected to be available for about eight weeks. Private schools that choose to participate will also receive the vaccine. Children will get an injection or a nasal spray form of the vaccine, and those younger than 10 years old will need two doses to be fully protected. New York Times

Weekly Feature

Check out Health Link BC’s H1N1 symptom checker- an online source of trusted health information. Health Link BC

Want to get the H1N1 vaccine as quickly as possible? Find the nearest clinic to you in British Columbia with provincial Flu Clinic Locators. CTV

Global's H1N1 Update - 10/20/09

The next update will be on Thursday, October 22nd, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 11th, 2009

National News

“British Columbia is now well into what we might call the second wave of the H1N1 pandemic,” Dr. Perry Kendall, B.C.'s provincial health officer, announced at a news conference at the B.C. Centre for Disease Control. British Columbia has seen a significant and sudden rise in cases, registering its eighth death earlier this week as health officials grapple with a flu outbreak that is unprecedented for the province this time of year. “Compared to the rest of the country we are seeing significantly higher numbers of influenza-like illness at this time,” Kendall added. Canadian Press

Health officials have confirmed the eighth death in B.C. from swine flu. The latest victim is Ashley Miller, 26, of Mission, who died Sunday, two days after she was admitted to Abbotsford Regional Hospital. Miller's friends said she was fit and healthy before becoming ill about a week ago. One friend said her death was very sudden, mysterious, and sad. The BCCDC said 78 people in the province have been sent to hospital because of swine flu, and officials are expecting more deaths from the virus. CBC

According to the results of a recent poll, a quarter of Quebec workers and a third of male employees would forego a day of rest and head into the office even if they were diagnosed with the H1N1 flu virus. The findings of a survey conducted by Quebec's Ordre des conseillers en ressources humaines also suggested that a majority of Quebec workplaces are not prepared for a potential flu pandemic and the bulk of their employees are not taking adequate precautions to ward off infection. Ordre president Florent Francoeur said the poll results expose a pattern of risky behaviour and show Quebecers do not fully appreciate the degree to which infections can spread in the workplace. Edmonton Sun

A 15-year-old boy in Timmins, Ontario, who died after contracting the H1N1 virus, had an underlying medical condition. Lynn Leggett, the manager of infectious diseases at the Porcupine Health Unit, says the condition would have contributed to his death. The swine flu-related death reported last week was the first in the northern Ontario city. A second 15-year-old boy diagnosed with the H1N1 virus continues to recover at home. Canadian Press

International News

Three handball players from China's 11th National Games have tested positive for the pandemic H1N1 virus. Anhui and Hebei handball teams were scheduled for the opening match of the event on Sunday. However, it was canceled due to the influenza. Local organizing committee vowed to prevent the outbreak of the influenza and provided H1N1 vaccines to the most vulnerable groups, including volunteers and workers related to the Games. China Daily

The U.S. Agriculture Department (USDA) has announced that the pandemic H1N1 flu virus was confirmed in a sample from a hog exhibited at the Minnesota State Fair. Additional samples are being tested. In a statement, USDA said the discovery does not suggest infection of commercial herds, grown for slaughter, because show pigs and commercial herds are separate components of the swine industry and usually are not commingled. Reuters

Antiviral News

A Food and Drug Administration (FDA) official said the agency would make a decision “fairly soon” about permitting emergency use of the experimental antiviral drug peramivir to help patients severely ill with pandemic H1N1 influenza. The FDA has been reviewing a possible emergency use authorization (EUA) for peramivir, which, like Tamiflu and Relenza is a neuraminidase inhibitor. Peramivir can be given intravenously or intramuscularly, whereas oseltamivir is taken orally and zanamivir is inhaled as a powder. CIDRAP

Vaccine News

Health Minister Leona Aglukkaq announced that Canada has shipped two million doses of swine flu vaccine to provinces and territories. The federal government is expected to approve the release of the H1N1 vaccine this week. Local health authorities will be able to start administering the vaccine once approval is granted. The two million doses all included a chemical booster known as an adjuvant. CBC

Provincial health officials are warning of a delay of up to two weeks between the general vaccine and the one designed for use by vulnerable groups such as expectant mothers. In September, federal health officials said they would have a small store of vaccine without adjuvant (an additive used to boost the vaccine’s power) available for “vulnerable groups” – specifically pregnant women – at the same time as the general vaccine. This was being done as a “precautionary measure” since there are no clinical data about the effects of adjuvant on expectant mothers. Now, senior public health officials in Ontario and British Columbia say that goal won’t be met. That would leave pregnant women in Canada with the difficult choice of opting for immediate inoculation when the general H1N1 vaccine becomes widely available in late October or early November, or wait for the vaccine that federal health authorities recommend for expectant mothers. The Globe and Mail

A local Israeli paper, Ha'aretz, has reported that the first H1N1 vaccinations have arrived in Israel and 350,000 doses are expected to be there by the end of this week. The team advising the Israeli Health Ministry on handling epidemics decided that the first vaccinations would be administered to medical staff and to chronically ill patients between the ages of 10 to 65. Some 3,000 H1N1 cases have so far been confirmed across the nation with a population of about 7 million. China View

Following a government decision to prioritize recipients of the limited vaccine supply, Japan has started vaccinating doctors and other health professionals against H1N1 swine flu . One million medical workers will be receiving the vaccine, followed by pregnant women and people with certain chronic diseases in November. The ministry official said the first batch will have enough doses to treat about 1.18 million people. Medical News

A judge on Friday morning halted enforcement of a New York State directive requiring that all health care workers be vaccinated for the seasonal flu and swine flu. The State Department of Health vowed to fight the restraining order, saying that the authorities “have clear legal authority” to require vaccinations, and noted that state courts had upheld mandatory vaccinations of health care workers against rubella and tuberculosis.The New York Times

Weekly Feature

Take an online self diagnosis test, licensed by Emory University and endorsed by the CDC, to check if you have the H1N1 flu or not: Microsoft

Global's H1N1 Update - 10/15/09

The next update will be on Tuesday, October 20th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 4th, 2009

National News

Health Minister Leona Aglukkaq has announced funding of $2.4 million over two years to support five new research projects on the H1N1 flu virus. The research will be funded through the Canadian Institutes of Health Research. The projects include research into high risk groups, complications in pregnant women, new drug treatments for severe infections, and immune-based preventive and treatment strategies. CBC

Dr. Kami Kandola, the top public health official in the Northwest Territories, says the fall wave of swine flu is spreading faster than expected and becoming more common than the common cold, citing higher numbers of people reporting influenza-like illness, calling the flu line, and visiting the emergency room. Cases of swine flu were identified in 22 of the territory's 33 communities as of last week. Health officials say schools are reporting more students calling in sick, but no school closures have been reported to date. CBC

Prince Edward Island has launched a recruiting campaign to find retired licensed health care professionals who are willing to work if the swine flu severely hits the province. Officials with the Department of Health said advertisements for retired doctors, nurses, and laboratory technicians were published in local newspapers over the weekend because extra help might be needed if many health-care workers get the H1N1 virus. Between 300 and 400 people have retired in the last eight years and may be needed to provide long term and acute care across the province. CBC

International News

Health authorities are urging guardians of young children with flu-like symptoms to get them to a hospital as soon as possible. Dr. Kenneth Alexander, the University of Chicago's pediatric infectious disease chief, said there are common signs to indicate when both kinds of flu turn dangerous. A recent report from the CDC found that one-third of pediatric deaths from the new H1N1 virus were in children with no known underlying condition that would put them at risk. CTV

As the flu season starts, pork producers across the United States are crossing their fingers that the worst is behind them. The outbreak of "swine flu" in Mexico last April sent a shockwave through the pork industry, sending prices into a free fall and instigating pork bans by several countries even as researchers concluded that consuming and handling pork is not hazardous to humans. Currently, experts estimate that pork producers are losing approximately $30 to $35 per animal, a loss of almost $3 billion to the entire pork industry. Minot Daily News

Vaccine News

Canada's Olympic team should receive the swine flu vaccine on a priority basis to prevent an outbreak at the Winter Games, the team's top medical officer, Bob McCormack said amid reports that Canadian athletes who come down with the virus may be placed in quarantine. For McCormack, the Olympics provide a potential breeding ground for the H1N1 virus and that provides justification for making athletes a priority for the vaccine. The Public Health Agency of Canada said it has already decided not to give Olympic athletes vaccination on a priority basis because they have lots of time to get the shot before the competition. The International Olympic Committee has said it will not quarantine athletes who get sick at the Games. CBC

According to a simulation model of a pandemic outbreak reported in a new study in the Canadian Medical Association Journal, early action, especially rapid roll-out of vaccines, is extremely effective in reducing the attack rate of the H1N1 influenza virus. The model simulated a pandemic outbreak based on demographic information from London, a mid-sized city in Ontario, Canada, as well as epidemiologic influenza pandemic data. It looked at the impact of vaccination timing, school closures, and antiviral drug treatment strategies, as well as the effect of pre-existing immunity. Science Daily

The New York Civil Liberties Union demanded on Tuesday that the state health commissioner withdraw a new regulation requiring hundreds of thousands of health care workers to get both seasonal and swine flu vaccinations. Several labor unions have opposed compulsory flu vaccination, arguing that it could result in the punishment and even dismissal of workers who refuse, whether for religious, cultural, or other reasons, to be vaccinated. The regulation covers workers and volunteers who come into direct contact with patients, including nurses, doctors, and aides and even nonmedical staff members, like food service workers, if they enter a patient’s room. New York Times

Weekly Feature

Take an online self diagnosis test, licensed by Emory University and endorsed by the CDC, to check if you have the H1N1 flu or not: Microsoft

Global's H1N1 Update-10/13/09, 0830 hrs PST

The next update will be on Thursday, October 15th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of October 4th, 2009

National News

According to a new study, more than two-thirds of those who have fallen critically ill and died of H1N1 influenza in Canada are younger women. The research, published in the Journal of the American Medical Association, highlights that there are two distinct forms of the disease: In 99 per cent of cases, people get sick, stay home for a few days, and get better. But in about one in every 1,000 cases, patients become gravely ill and require staggering amounts of care. In fact, the research reveals that the large majority of those who became seriously ill had no serious underlying health conditions, contrary to what is often stated. The Globe and Mail

A new poll indicated that Canadians don't seem to see the H1N1 virus as a personal threat, and few currently plan to get vaccinated against the virus. The Canadian Press Harris-Decima poll suggests interest in the swine flu vaccine has declined in Canada, with only a third of people now saying they will get the shot, compared to 45 per cent in late August. “They're certainly disappointing and maybe a bit dismaying,” Dr. Perry Kendall, British Columbia's chief medical officer of health, said of the findings. Canadian Press

Google has unveiled a Canadian version of Google Flu Trends, a sophisticated flu-tracking Web tool that gathers data from the company's search engine and crunches it down to create a near real-time picture of the level of influenza infection in a given area. Google developed Flu Trends to provide public health agencies with a new means of tracking trends during flu season as a way of preventing outbreaks. Google Flu Trends first launched in the United States last November, with subsequent versions appearing in Mexico in April and in Australia and New Zealand in June. National Post

International News

In the Northern Hemisphere, transmission of influenza virus and rates of influenza-like-illness (ILI) continue to increase marking an unusually early start to fall and winter influenza season in many countries. In Europe and Central and Western Asia, early transmission of influenza virus continues to increase in many countries, with more intense focal activity being reported in a few. In the tropical regions of the Americas and Asia, influenza virus transmission persists, however influenza activity remained variable. In the temperate regions of the southern hemisphere, influenza transmission has largely subsided (Chile, Argentina, and New Zealand) or continues to decline substantially (South Africa and Australia). WHO

Egypt has closed two schools and two university departments in Cairo and began putting lessons on television in an effort to contain swine flu after several cases of the disease among students. A boys school and a girls school in two Cairo suburbs and the language and arts faculties at Ain Shams University are being closed for two weeks. A classroom at the American University in Cairo was also shuttered after a student came down with the H1N1 virus over the weekend. Bloomberg

Health authorities in Jordan have recently confirmed the country’s first death of influenza H1N1. The victim, a 26-year old man, was admitted to the state-run Prince Hamzah Hospital late on Sunday after exhibiting symptoms of the H1N1 virus. In remarks to the Jordan's official News Agency Petra, Jordan's Health Minister Nayef Fayez said the young man had suffered from unrelated health problems prior to his infection. Xinhua

Cuba has acknowledged its first deaths from swine flu, saying three pregnant women succumbed to the virus and many more have been treated for symptoms. Deputy Health Minister Jose Angel Portal said a total of 2,100 pregnant women were treated for symptoms of the disease, with 110 of them seriously ill, in comments reported by the official Communist Party newspaper. The report does not say how many women remain hospitalized, nor make clear whether all of the 2,100 cases were confirmed to be H1N1. Associated Press

Vaccine News

The World Health Organization has said that it hopes to begin shipping 60 million doses of swine flu vaccine to poor countries in November as part of an effort to protect their fragile health systems from the pandemic. WHO wants to provide doctors and nurses in about 100 countries with vaccines over the coming four to five months, using a stockpile provided by drug companies and donor countries. WHO has warned that poor countries risk being overwhelmed as health workers fall ill and are unable to care for patients with other diseases. Associated Press

The largest vaccination programme in Swedish history got underway as health workers in the south of the country received the first shots to protect against the swine flu. Hospital workers lined up at Malmö University Hospital to be among the first people in Sweden to receive vaccinations against the AH1H1 virus. The swine flu vaccine arrived in the area on Monday morning before being distributed in refrigerated trucks to ten nearby hospitals. The Local

The UK Department of Health (DH) has ordered health officials across England to ensure that frontline staff get immunized against swine flu amid growing signs that many doctors and nurses intend to shun the vaccine. Chief executives and boards who run hospitals, primary care trusts, and strategic health authorities have been told to urgently maximize the number of workers having the jab. Leading DH figures, including Sir Liam Donaldson, the chief medical officer, have written to them six times in the last five weeks stressing the need for action before the second wave of the pandemic causes major problems. Guardian

Weekly Feature

Check out global flu trends through Google by clicking here.

Global's H1N1 Update - 10/08/09

The next update will be on Tuesday, October 13th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of 27th September, 2009

Local/National News

Leona Aglukkaq, Federal Health Minister, was challenged in the House of Commons to explain why Canada's vaccine won't be ready until November when some other countries have already started immunization programs. She was also sent an open letter by the Liberal party outlining a number of actions it wants the government to take. Chief Public Health Officer Dr. David Butler-Jones has previously said that Canada's vaccine timeline was partly determined by the decision to complete production of the seasonal flu vaccine before starting the H1N1 vaccine. “We are not delaying the vaccine. The vaccine will be widely available to all Canadians during the first week of November,” confirmed Aglukkaq. Canada.com

A new scientific study has found that receiving the seasonal flu shot may help boost immunity against swine flu, contrary to the widely publicized study which concluded that the seasonal flu shot increased susceptibility to the H1N1 virus, causing most Canadian provinces to postpone seasonal flu vaccination campaigns. The study found that people with laboratory-confirmed swine flu at a hospital in Mexico City were less likely to have received the flu shot in the previous winter compared with patients with other diseases. David Jensen, spokesman for Ontario's Ministry of Health and Long-Term Care, said the province is not reconsidering its vaccination campaign as a result of the Mexican data. He said the Canadian study was not the only reason behind the ministry delaying the seasonal flu vaccine for certain groups. The H1N1 strain is expected to be the main strain circulating this fall, and staggering vaccination programs would provide less of a logistical challenge this season, he added. Globe and Mail

International News

The Government of Mexico hosted a meeting with senior officials from Canada and the United States as part of ongoing North American efforts to address the challenges posed by the pandemic H1N1 virus. The objectives of the meeting were for the three countries to take stock of efforts to date, and to continue sharing lessons learned and strategies to further prepare for a second wave of the virus. The Mexican delegation was led by Mauricio Hernandez, Deputy Secretary of Health Prevention and Promotion of the Ministry of Health. The United States was represented by Deputy Secretary of Homeland Security Jane Holl Lute, and Dr. Gerald Parker, Principal Deputy Assistant Secretary for Preparedness and Response of Health and Human Services. Canada was represented by the Deputy Minister of Health Morris Rosenberg and the Associate Deputy Minister of Public Safety Myles Kirvan. PHAC

The Chinese Health Ministry has reported that a woman in the Tibetan capital of Lhasa has become China's first swine flu fatality. It gave no other details but the Xinhua News Agency said the patient was an 18-year-old woman who died at a hospital in Maizhokunggar County, part of Lhasa. China's mainland had 21,453 confirmed cases of H1N1 flu. About 78.7 per cent of the patients have recovered. CTV

The Brazilian government will allocate $1.18 billion for the purchase of vaccine and diagnostic material against swine flu that has so far caused the deaths of 899 people in this country. The vaccine, diagnostic material and other equipment will be purchased during the coming months in order to have “redoubled protection” before next winter in the Southern Hemisphere, when another wave of the flu is expected. The Butantan Institute, a laboratory belonging to the Sao Paulo state government, is working on the production of a vaccine against the new virus and estimates that by the beginning of next year it will have stockpiled some 18 million doses. Health News

Tunisians will not be allowed to travel to Saudi Arabia for the Muslim pilgrimage or Haj because of fears of the H1N1 virus. No other country has yet said it would prevent its citizens from making the pilgrimage to Saudi Arabia in late November. Tunisia and Iran barred their citizens from making the Umrah pilgrimage this year because of fears of the virus. But whereas the Umrah pilgrimage is optional, every Muslim who is able must make the Hajj once in their lifetime. Health News

Vaccine News

Children in several states in the US, including New York, recently received nasal spray vaccines with shots due to begin next week. Dr. Thomas A. Farley, New York City’s new health commissioner, said he expected a vaccine shortage until the end of the month, when a batch of 1.2 million is scheduled to arrive. Public school officials hope to begin giving vaccines in elementary schools at the end of the month and will send consent forms to parents. Middle and high school students will be offered shots on weekends. New York Times

Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, sought to dispel common misperceptions that this flu should ever be called a “mild disease,” that the vaccine is untested and that it has arrived too late. Even in areas of the U.S. where the swine flu virus is widespread, about five to 10 per cent of the population has been affected, meaning 90 to 95 per cent are still susceptible. "The flu vaccine is our best weapon against the flu," Frieden said, noting that adverse reactions will be carefully tracked. CBC

Despite pressure to speed up the start of the program, Canada’s chief public health officer continued to insist that the projected start date of the Canadian H1N1 vaccination program is still early November. This date will allow Health Canada to follow the regulatory process it set out for approving the pandemic vaccine, Dr. David Butler-Jones said. Dr. Perry Kendall, British Columbia's chief medical officer of health, said provinces and territories would need at least a week or two of notice to get clinics organized and staffed if the start date is going to change.
CTV

Global's H1N1 Update - 10/06/09, 0830 hrs PST

The next update will be on Thursday, October 8th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

Local/National News

Several provinces and territories plan to ask retired nurses to return to work if the swine flu pandemic becomes severe in Canada. While Quebec constantly updates its list of recently retired nurses in case of an emergency, Manitoba, Nova Scotia, New Brunswick, Quebec, Alberta, Yukon, and British Columbia are all actively looking for both retired and non-practicing nurses. Recently, New Brunswick's nursing college launched an online appeal for retired nurses to register. CBC

Research done in 2007 and presented by the Canadian Medical Association Journal has found there is no evidence that hand washing prevents the flu. The report, commissioned by the Public Health Agency of Canada stated that current evidence shows flu is primarily spread through the air. Despite the results, the Public Health Agency of Canada continues to recommend hand washing to prevent the flu because there is "substantial evidence" to support washing to prevent infection. CTV

International News

In North America, influenza transmission is geographically widespread and continues to increase above the seasonal baseline. Rates of influenza-like-illness continue to be above baseline levels in Ireland, parts of the United Kingdom (Northern Ireland), Israel, and France; in addition, more than 10 other countries in the region have reported geographically localized spread of influenza. Throughout the tropical region of the Americas, many countries, like Bolivia, Brazil, Costa Rica, El Salvador, Panama, and Paraguay have been recently reporting a declining trend. In tropical regions of Asia, there continues to be an increasing trend in respiratory diseases in parts of India and in Cambodia. WHO

Influenza A/H1N1 has hit a third school in Uganda as 13 students were confirmed with the epidemic, bringing the total cases in the country to 58. The new cases were confirmed at Ndejje secondary school in Luwero district, central Uganda. Another 30 students are being monitored at an isolation unit at Ndejje school, said Issa Makumbi, head of disease surveillance at the Health Ministry. The earlier outbreaks in two secondary schools in Bushenyi and Kabarole district have left 19 students confirmed with the flu and over 300 more under medical surveillance. China View

Swine flu is now widespread across the entire United States, the Centers for Disease Control and Prevention announced as federal health officials released Tamiflu for children from the national stockpile and began taking orders from the states for the new swine flu vaccine. Dr. Anne Schuchat, the disease control center’s director of immunization and respiratory disease, said there was “significant flu activity in virtually all states,” which, she added, was “quite unusual for this time of year.” New York Times

Doctors in Australia and New Zealand have found that swine flu is most dangerous when it causes the lungs to become inflamed, flood with fluid, and fail to function. While a majority of people infected with the virus have a mild illness, a small number develop life-threatening disease. The doctors described the most common of three main complications from the pandemic strain as flu A-associated acute respiratory disease syndrome, or “flaards.” Flaards -- sometimes with associated multiple organ failure -- is the most common syndrome and has the highest attributable mortality. Bloomberg

Vaccine News

The swine flu vaccine has arrived in parts of the U.S., with vaccinations due to begin on October 5th. Vaccination clinics are scheduled for staff at Le Bonheur Children's Medical Center in Memphis, Tennessee and Wishard Health Services in Indianapolis, in which the vaccine will be given to doctors, nurses, emergency medical workers and other health care professionals who work directly with patients. The first vaccines to be administered in the U.S. will be a nasal spray from AstraZeneca unit MedImmune. The U.S. government has ordered about 250 million doses of both injectable and nasal spray vaccine from Sanofi-Aventis SA, CSL Ltd, MedImmune, Novartis AG and GlaxoSmithKline. Seasonal flu vaccination programs are also underway in the U.S., having begun last month. CTV

International influenza vaccine experts are apparently not convinced that Canadian researchers have found a true link between getting a seasonal flu shot and catching swine flu. The consensus arrived at during a WHO teleconference on the controversial data believed that the Canadian findings are likely due to some confounding factor or factors in the data themselves and may not reflect a real increased risk, according to David Wood, coordinator of the quality, safety and standards team of WHO's department of immunization, vaccines and biologicals. Scientists from the United States, Britain and Australia have looked at their data, but didn't see the same effect. CBC

Week’s Feature

Watch the spread of the H1N1 virus through global air traffic routes in this study published in the New England Journal of Medicine. NEJM

Global's H1N1 Update - 10/1/09, 0830 hrs PST

The next update will be on Tuesday, October 6th, at 0830 hrs PST.

The WHO Pandemic Alert level remains at Phase 6

Influenza A (H1N1) Cases and Deaths

*Cases reported by The World Health Organization (WHO) are as of 20th September, 2009

Local/National News

A Canadian principal teaching in a Hong Kong school may have died of swine flu. Alan Dick, 55, a Toronto-educated lower school principal at the Canadian International School of Hong Kong, died in hospital on September 28th. Lab tests on respiratory specimens taken from Dick posthumously were confirmed positive for the influenza A H1N1 virus. The school has more than 1,600 students ranging in age from three to 18. About half of those students are Canadians. The Star

A Winnipeg doctor, Dr. Anand Kumar, is working with Cangene, a world-renowned and Winnipeg-based biopharmaceutical company, hoping to develop an alternative treatment for those who contract the H1N1 virus. Until now, the only treatment options for people with the H1N1 flu virus have been the antiviral drug Tamiflu and to put people with serious respiratory problems on ventilators. Cangene is now searching for former H1N1 patients to donate their plasma. The idea is that antibodies from those who have already recovered from H1N1 can be used to help flu patients. CBC

The Canadian Forces reserves the right to order its soldiers deployed in Afghanistan to take the vaccine meant to prevent swine flu, says the military's Surgeon General, Commodore Hans Jung. The current plan is to make the H1N1 vaccine, expected to be available in November, voluntary for soldiers, sailors and aircrew throughout the Canadian Forces, including those on duty in Kandahar and elsewhere around the world. But the Chief of Defence Staff does have the legal authority to order soldiers to take the shot. Jung said the possibility of a swine flu pandemic, with an army fighting in the field, presents National Defence and the military's health services branch with a unique challenge. One of the complicating factors in that equation is that Canadian troops share the airfield with more than 15,000 other NATO troops and patrol through regions where Afghans have little access to basic medical care and sanitation. CTV

International News

U.S. hospitals are opening drive-thrus and drive-up tent clinics to screen and treat a swelling tide of swine flu patients. People pull up, park and go through three tents, where they undergo an exam that includes having their temperature taken. Under a program at Stanford University in Palo Alto, California, many flu patients will not even have to leave their cars. The nurse near the ER stops cars and sends appropriate cases to the drive-thru. Signs tell families to tune the radio to a public broadcasting station that describes what happens next. The patient's automobile acts as a self-contained isolation compartment, the hoods of the cars make excellent places to write notes and medical records are slid under the windshield wipers. Through the car window, a doctor uses a device that clips on a finger to measure blood pressure, pulse and breathing rates. Fingerstick blood tests can be done. In nearby tents, diabetics can get a urine test for blood sugar, and heart patients can get an EKG. The last stop has a pharmacy to get vaccine, medicines or a prescription to fill. CTV

A study of 77 patients who died of the new pandemic H1N1 virus in the United States showed 29 percent of them had so-called bacterial co-infections, the U.S. Centers for Disease Control and Prevention reported. About half of these had Streptococcus pneumoniae, which can be prevented with a vaccine. Wyeth's Prevnar is part of the routine series of immunizations that children should get, and another vaccine against so-called pneumococcal bacteria is available for elderly adults. Reuters

Vaccine News

Australia has launched its H1N1 vaccination campaign for adults and children aged 10 and over, one of the first counties to do so. Health Minister Nicola Roxon said 5.5 million doses of the swine flu vaccine have been delivered across the country, enough to vaccinate about 30 per cent of the population. Those most at risk from the H1N1 virus — such as health-care workers, pregnant women, indigenous Australians and people with chronic diseases — are encouraged to get the pandemic flu shot as soon as it is available locally.CBC

Some injectable swine flu shots will become available earlier than expected, reported an executive of Sanofi-Aventis, the pharmaceutical company based in Europe, which has a flu vaccine plant in Swiftwater, PA. This is because Sanofi-Aventis has been able to finish making its vaccine nearly two weeks ahead of schedule. Until recently, nearly all the first vaccine batches were expected to be of the nasal spray form, a live virus that is not recommended for pregnant women, children under 2, adults over 50 and people with health problems. New York Times

Every year, there are 1.1 million heart attacks in the United States, 795,000 strokes and 876,000 miscarriages, and 200,000 Americans have their first seizure. Dr. Harvey V. Fineberg, president of the Institute of Medicine and health officials from the CDC are urging Americans not to associate all illnesses that occur in the following months with the H1N1 vaccine. Officials are particularly worried about spontaneous miscarriages, because they are urging pregnant women to be among the first to be vaccinated. Memories of the 1976 vaccine campaign surface- when what was believed to be the freakishly coincidental deaths of three elderly Pittsburgh residents after receiving the flu shots was attributed to the flu shot and the ensuing media storm derailed the program. New York Times

Week’s Feature

Listen to survivors of the H1N1 virus as former patients talk about their experiences with the pandemic flu. CBC