Global's H1N1 Update - 11/26/09

The next update will be on Thursday, November 26th, 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 November 15th, 2009

National News

Four more Albertans with H1N1 influenza have died, bringing the total number of deaths related to swine flu to 51 in this province. Alberta Health Services said the victims, who were all from the Edmonton area and all had underlying medical conditions. The most recent deaths come as the Alberta Liberals continue to criticize the government for its handling of the H1N1 vaccination program and the high rates of hospitalization and death in the province. Alberta's death rate from H1N1 flu is 11.39 per million people--nearly double the national average of 6.49 per million. Calgary Herald

According to provincial health officer, Dr. Perry Kendall, between 335,000 and 670,000 B.C. residents have been infected with H1N1 flu in the past few months. While there have been only 6,700 lab-confirmed cases, public health experts believe there are 65 to 135 actual cases for every lab-confirmed case. The falling numbers of deaths, emergency room visits, hospitalizations, and doctor visits, as well as lower numbers of H1N1 tests and antiviral medications dispensed, suggests the pandemic may have peaked. Vancouver Sun

International News

Dr. Debra Parsons, an American physician who claimed to have contracted the H1N1 virus twice now has her self-diagnosis confirmed by the Centers for Disease Control in Atlanta. Parsons first came down with the virus in August and then again in October. She was tested both times, and the results were the same – they were positive for influenza A. John Law, spokesman for the West Virginia Division of Health and Human Resources, said the possibility of getting the flu twice was "very, very, very rare." Charleston Daily Mail

The number of confirmed deaths reported by EU and EFTA countries due to the pandemic rose by two thirds in the last week to 169. Routine surveillance reports from primary care indicate that almost all European countries reported intensity above baseline levels. Seventeen countries showed increasing trends. The European Committee on Human Medical Products has strengthened its previous statement that a single injection of the vaccines Focetria and Pandemrix may be sufficient to protect children over age 10 and adults to age sixty. ECDC

The World Health Organization (WHO) warned that the Avian Influenza or A-H5N1 remains a threat to humans, with newly confirmed cases reported in Egypt, Indonesia, Thailand, and Vietnam. In a statement, WHO said the presence of the A-H5N1 in poultries in these countries poses a health risk in two ways. First, those in direct contact with birds are in danger of contracting the virus. Second, the virus can undergo re-assortment with another influenza virus, producing a new strain. Philippine Star

The World Bank Board of Executive Directors has approved a $US491 million loan for influenza virus prevention and control in Mexico. Some of the goals of this project include: improved performance of SINAVE, the national epidemiological surveillance system; vaccination of more than 10 million Mexicans against influenza A/H1N1; 2.15 million antiviral treatments stockpiled in the country’s strategic reserves; and establishing the central epidemiological analysis unit and state epidemiological offices. World Bank

Vaccine News

According to Canadian Health Minister, Leona Aglukkaq, by the end of this week, more than 15 million doses of the H1N1 vaccine will have been distributed to provinces and territories, enough to immunize half the population. So far, one-quarter of Canadians, more than eight million people, have received the H1N1 vaccine. At least three million more doses will be available next week. In most parts of the country, H1N1 shots are available to all, and lineups have dwindled. CBC

Dr. David Butler Jones, head of the Public Health Agency of Canada, has confirmed 24 cases of a type of severe allergic reaction called anaphylaxis in Canadians who have received an H1N1 flu shot, including one person who died after getting vaccinated. It is still not clear whether the vaccine or health problems caused the death. Anaphylaxis is a severe allergic reaction that can cause a person's airways to close up and must be treated quickly with adrenaline. Canadian Press

Quebec will become the latest province to start vaccinating the general population for the H1N1 flu. Health Minister Yves Bolduc says Quebec will begin inoculating the general public by November 25th in several regions of the province after receiving a large shipment of the vaccine. Bolduc says health workers in the rest of the province are expected to get the green light next week to begin vaccinating the general public. Canadian Press

Mass immunization clinics for the H1N1 vaccine in Manitoba are slated to wrap up in two weeks and health officials are urging people to get the shot while they can. Dr. Sande Harlos, the medical officer of health for the Winnipeg Regional Health Authority, said the amount of people who have been immunized represents about 27 per cent of the city's population. She would like to see the number closer to 40 or 50 per cent by the time the campaign is over. In total across the province, about 300,000 people have been vaccinated. CBC

Mexico's health ministry announced that it had received its first 865,000 doses of pandemic H1N1 vaccine. The country's health secretary, Jose Angel Cordova, said officials will review the vaccine and administer the first doses this week to pregnant women and health workers. He said Mexico expects 7 million doses by the end of 2009 and 30 million doses by February 2010 from Sanofi and GlaxoSmithKline. Latin America Herald Tribune

Weekly Feature

Find updated guidelines on the H1N1 pandemic vaccine, including recommended recipients, dosages, and routes of administration, from the Public Health Agency of Canada

Global's H1N1 Update - 11/24/09

The next update will be on Thursday, November 26th, 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 November 15th, 2009

Vaccine News

Public health officials in Winnipeg say unusually low numbers of people are attending clinics to be vaccinated against the H1N1 virus. The Winnipeg Regional Health Authority reported that clinics on November 20th attracted 4,400 people, a drop from previous averages of 16,000 people per day. CBC

The H1N1 flu vaccine is now available to every British Columbian after a week of low turnouts at immunization clinics, some of which have operated at as little as 50 per cent capacity. Vancouver Sun

Alberta's H1N1 vaccination clinics opened to the general public on November 23rd for the first time since late October when long lineups and vaccine shortages prompted the province to suspend the program and reopen it for high risk groups only. CBC

Quebec's health minister, Yves Bolduc, is optimistic that the general population of Montreal will be able to get their H1N1 flu shot earlier than December 7th. However, this move will hinge on the number of new doses being shipped in the coming days. Regardless, Bolduc says an announcement should be made in the near term. CJAD

Nova Scotia expanded its H1N1 flu vaccination campaign on November 20th to include the general public. Dr. Robert Strang, Nova Scotia’s medical health officer, said officials felt comfortable in opening up the program because a steady supply of vaccine is expected in the coming weeks. Canadian Press

The Public Health Agency of Canada and vaccine manufacturer GlaxoSmithKline have asked the governments of Manitoba, British Columbia, Alberta, Saskatchewan, Ontario, and Prince Edward Island to stop using a batch of 172,000 doses. Six allergic reactions occurred from the same batch, a higher percentage than usual, according to a spokeswoman for the Public Health Agency. Overall, the number of severe allergic reactions following H1N1 vaccinations is less than 1 per 100,000 doses, the norm for other vaccines. All six people who experienced the allergic reactions have recovered. Reuters

Novartis will officially open the first next-generation flu vaccine plant in the United States this week, but it will be years before it makes its first vaccine. The factory in Holly Hill, North Carolina, will use batches of dog cells to grow influenza vaccine, instead of the chicken eggs widely used now. While the cell method is only slightly faster, it can be scaled up more quickly. Reuters

National News

The Public Health Agency of Canada says that the number of outbreaks at schools and hospitals, the prevalence of flu-related doctor visits, and the number of flu cases for testing across the country has declined, leading to suggestions that the pandemic has peaked. In Ottawa, the number of flu cases fell far enough for local health authorities to close all but one of the city's flu assessment clinics. In Vancouver, a flu clinic at the B.C. Children's hospital also shut down as the number of patients eased. South of the border, fewer Americans are visiting their doctor because of H1N1, according to the Centers for Disease Control. Absentee rates at U.S. schools have returned to normal as well.. CTV

A Vancouver Coastal Health review has found that Richmond Hospital was not at fault in the death of a Richmond, B.C. woman who died of H1N1 after being sent home from the hospital twice. Mae Mah, 51, died of H1N1 on November 1st, hours after being sent home from Richmond Hospital. She had also been to the hospital the day before. Mah had asthma, and had been experiencing breathing problems and fever, but H1N1 was not diagnosed until after her death. Vancouver Sun

International News

In temperate regions of the northern hemisphere, the winter influenza season continues to intensify across parts of North America and much of Europe. However, there are early signs of a peak in disease activity in Western Europe. Further east, Serbia, Norway, Lithuania, Bulgaria and Ukraine reported sharp increases in the rates of flu-like symptoms. In Central and Western Asia, increasing diseases activity and pandemic influenza virus isolations continues to be reported in several countries. In East Asia, influenza transmission remains active. In the tropical areas of Central and South America, most countries continue to report declining influenza activity. With the exception of Sri Lanka, flu activity is declining in tropical South and Southeast Asia. WHO

The Norwegian Institute of Public Health has informed the WHO of a mutation detected in three H1N1 viruses. The viruses were isolated from the first two fatal cases of pandemic influenza in the country and one patient with severe illness. Norwegian scientists have analyzed samples from more than 70 patients with clinical illness and no further instances of this mutation have been detected. The virus with this mutation remains sensitive to the antiviral drugs, oseltamivir and zanamivir, and studies show that currently available pandemic vaccines confer protection. WHO

Officials from Japan, China, and South Korea have agreed to share information on food safety and coordinate measures against the outbreak of the H1N1 influenza virus. The Japanese minister of health, labor and welfare, the Chinese health minister and the South Korean minister of health, welfare and family affairs, took part in talks held in Tokyo on November 23rd. Xinhua

Uzbekistan has closed its border with central Asian neighbor Kazakhstan to all but citizens of each nation returning home, as H1N1 spreads in both countries. The World Health Organization reported that Kazakhstan, Uzbekistan, and parts of Afghanistan were reporting higher numbers of flu cases. Reuters

According to the French influenza surveillance system, nearly 2 million French residents have been infected with the H1N1 virus since August. French Health Minister Roselyne Bachelot announced that 200,000 persons thus far have received vaccine injections and urged the vaccination campaign to go "on full acceleration" because of increased virus activity. China View

China's Ministry of Health has ordered all administrative and medical departments to ensure accurate reporting of H1N1 influenza cases, in response to a medical expert from the Chinese Academy of Engineering saying that he did not believe there had been only 53 deaths from the H1N1 virus nationwide. Allegedly, some areas had left dead patients undiagnosed in order to conceal the number of deaths from the flu. The ministry had dispatched nine teams to 12 provinces and autonomous regions to oversee prevention and treatment of the flu, especially treatment of severe cases. China View

Weekly Feature

Find updated guidelines on the H1N1 pandemic vaccine, including recommended recipients, dosages, and routes of administration, from the Public Health Agency of Canada

H1N1 Update - 11/19/09

The next update will be on Tuesday, November 24th, 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 November 8th, 2009

Vaccine News

Manitoba Health has announced that on November 18th, the general public will be able to receive the pandemic H1N1 vaccine. Joel Kettner, Manitoba's chief public health officer, said the decision to eliminate the priority list was based on dwindling demand among the priority group and an upward swing in the supply of vaccine arriving weekly. Winnipeg Sun

Ontario Health Minister Deb Matthews has announced that starting November 18th, anyone in Ontario over the age of six months will be able to get vaccinated against the H1N1 virus. CTV

According to Quebec Health Minister Yves Bolduc, by November 22nd, more than 1.3 million Quebecers would have been inoculated against the H1N1 virus. The number of new hospitalizations, still on the rise, is not as worrisome as health authorities initially expected, though some regions, such as Montreal's South Shore, are reportedly being hit harder than others. Ottawa Citizen

Newfoundland and Labrador Health Minister Jerome Kennedy says he is considering making senior citizens the next candidates for vaccination, even if it means overruling the advice of medical experts. Health officials have said people over the age of 65 are considered to have a lower risk of becoming infected with the H1N1 virus than other members of the population. CBC

Alberta’s H1N1 immunization program will expand at the end of this week to include all children under 18, as well as their family and caregivers. And it may expand even further, depending on demand for the vaccine over the weekend. Immunization for seniors will expand shortly to include those 65 years old and above, as well as their spouse or partner of any age. Edmonton Sun

Prince Edward Island will begin vaccinating the general population by November 30th. The PEI Health Department is getting ready to make expected long lines at H1N1 vaccine clinics easier to manage with an arm band system. Charlottetown Guardian

As Canadian health officials assured the public that the pandemic H1N1 vaccine is as safe as the seasonal flu shot, British Columbia Centre for Disease Control said it is probing why B.C. residents are suffering anaphylaxis, an adverse reaction to the vaccine, at a higher rate compared with the previous five seasonal flu vaccination programs. In British Columbia, the rate of adverse reactions is 2.2 per 100,000 doses distributed, compared to 1.2 per 100,000 doses usually. None of the 18 anaphylaxis reactions in B.C. resulted in death. Globe and Mail

Prisoners and staff at Newfoundland's largest prison have been given the H1N1 vaccine to reduce the spread of the virus. The Eastern Health district said the inmate population at Her Majesty's Penitentiary in St. John's was identified as an at-risk group by the Public Health Agency of Canada. Inmates and others in closed correctional facilities are considered at-risk because they live in a confined environment that makes them vulnerable to the spread of a virus. Canadian Press

National News

With more than half of Toronto Public Health's staff deployed to work related to the H1N1 influenza pandemic, some regular programs have been suspended, including sexual health clinics, home visits for new mothers, and some food safety inspections. The impact has been greatest due to nurses being redeployed to work in 10 public vaccination clinics. Health Zone

Teachers in some B.C. public schools have started refusing to work because they contend that the H1N1 illness among students has created an unsafe workplace. By law, employees have a right to refuse work if there is a reasonable cause to believe it poses a health or safety hazard. The teachers' claims of unsafe work prompted an onsite inspection by WorkSafeBC which did not identify a single worksite that was hazardous due to the virus. The B.C. Public School Employers' Association has advised school districts that, based on the WorkSafeBC findings, “it will not be deemed to be unsafe… to go to work in the classroom where the potential to contract H1N1 exists.” Vancouver Sun

International News

51 French schools have been closed due to possible spread of the H1N1 virus or emergence of confirmed cases, according to the French Education Ministry. Since the epidemic broke out in France, the government has granted the regional prefects right to close classes or even schools if three flu cases emerge in the same class during one week or cross infection are possible for different classes sharing same activities. Xinhua

According to a survey of doctors, more than half of Britons being offered vaccination against pandemic H1N1 flu are turning it down because they fear side effects or think the virus is too mild to bother. Many of the 107 family doctors polled by Britain's Pulse magazine said there was widespread resistance from patients, particularly pregnant women, and on average only 46 percent of those offered the vaccination would agree to receive it. Reuters

A new study of pandemic H1N1 cases in Mexico, by Dr. Victor Borja-Aburto of the Mexican Institute for Social Security, and colleagues, found the death rate was above 10% in those aged 70 or older, 5.7% among those aged 60 to 69, 4.5% among those 50 to 59, 2.7% for those 40 to 49, 2% for those 30 to 39 years and 1.6% for infants under the age of one. In terms of catching the disease, those aged 10 to 39 were most affected, comprising 56 per cent of all cases in the study that were confirmed as H1N1 flu. Canadian Press

Another 42 people have died of H1N1 flu in Iran over the past week, raising the Islamic republic's death toll from the illness to 100. Iran has placed restrictions on Muslims planning to travel to Mecca in Saudi Arabia for the annual hajj pilgrimage later this month. Straits Times

Eighteen more people have died in South Korea from the H1N1 virus, raising the country's total death toll from the new flu to 82. An 11-year-old girl and a 42-year-old man died after being diagnosed with the H1N1 virus, both of them not classified as being in the high-risk category and given antiviral medication. Korea Times

Global's H1N1 Update - 11/17/09

The next update will be on Thursday, November 19th, 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 November 8th, 2009

Vaccine News

A number of groups in British Columbia are now eligible for the vaccine, including firefighters, people 65 and older with chronic health conditions, healthy children from five to 18 years old, and health care workers delivering acute care, long-term care, home care, and public health services. Vancouver Sun

Children younger than 10, seniors and anyone with compromised immune systems, who are not eligible for the unadjuvanted vaccine, will not be able to get the H1N1 vaccine in Winnipeg on November 16th as vaccine shipments were delayed. Winnipeg Sun

Alberta will be offering H1N1 flu vaccine to the general public later this week, with a gradual introduction to avoid the hours-long lineups that arose early in the mass immunization campaign. Seniors will be the first group phased into the program. CBC

10 H1N1 vaccination clinics in Toronto, Ontario will now be open seven days a week, starting Monday. Children from six-months of age to 13 years old and those with a chronic health condition, as well as those over the age of 65, are now included in the high-priority group. 680 News

Dr. Robert Strang, the chief public officer of health for Nova Scotia, has announced that pregnant women and people between the ages of 10 and 64 with a chronic illness who are otherwise healthy will now be able to get injected with the unadjuvanted vaccine. Chronicle Herald

Public health authorities in Quebec opened new vaccination centres on November 16th, including a mega-clinic at the Palais des Congrès in Montreal, to keep up with demand for inoculation. The Palais des Congrès clinic has the ability to vaccinate up to 300 people per hour according to Montreal's Public Health Agency. CBC

The Public Health Agency of Canada announced it is changing its recommendation for healthy children aged three to nine, saying they probably do not need a second shot of the vaccine to be protected. The decision is based on promising data, scarcity of vaccines, and is a position advocated by the WHO. The agency said kids aged three to nine with chronic diseases may need a second shot and infants and toddlers aged six to 35 months should get two shots of the vaccine. The agency reserved the right to revisit the decision in the future if newer scientific data point to a need for two doses for these children. Canadian Press

National News

According to experts at the Ottawa Health Institute, comparing seasonal flu fatalities to H1N1 deaths is absolutely statistically unfounded since seasonal flu numbers are estimates and mathematical calculations aimed at capturing all the deaths influenza had a hand in. The H1N1 figures count deaths directly attributed to the pandemic virus. A 2007 study looking at 10 years worth of influenza deaths in Canada reported that deaths directly attributed to seasonal flu made up only eight per cent of all influenza-related deaths in a given year. Canadian Press

Canada's chief public health officer, Dr. Butler-Jones officer has commented that the H1N1 pandemic virus appears no deadlier than regular seasonal influenza and that there could actually be substantially fewer flu deaths than normal this season. Although H1N1 is disproportionately infecting more children and otherwise healthy young adults, according to Dr. Butler-Jones, the mortality rate is no worse than seasonal flu. Canada's national pandemic plan estimated a flu outbreak could cause 15 to 35% of the population to fall clinically sick, and force the hospitalizations of 34,000 to 138,000 people. So far, an estimated seven to eight per cent of the population has been infected in the first and second wave. National Post

Opposition Liberal MPs have asked the federal government to translate information about H1N1 into minority languages, ranging from Chinese to Arabic to Farsi, to allow ethnic Canadians to properly understand the disease. Several local public health units across Canada have ended up having to use their own limited resources to translate information about the virus and vaccine. The opposition also wants the Conservative government to reactivate a 2004 contingency fund brought in by the Liberals to assist public health initiatives in the event of a pandemic. Toronto Sun

B.C.'s Provincial Medical Officer of Health, Dr. Perry Kendall, has commented that B.C. is likely through the second wave of the H1N1 flu outbreak and a third wave is unlikely. Kendall says every region in B.C., except for the north, has seen a decrease in doctor-patient visits. News 1130

International News

In the United States, Europe, and Central Asia, influenza transmission remains geographically widespread and intense. In Europe and Central Asia, overall influenza transmission continues to intensify throughout the continent as pandemic activity spreads eastward. High to very high intensity of respiratory diseases with concurrent circulation of pandemic H1N1 2009 was reported in many countries in the area. WHO

In Western Asia, increasing activity has been observed in several countries like Israel and Afghanistan. In East Asia, very intense and increasing influenza activity continues to be reported in Mongolia with a severe impact on the healthcare system. Most countries in the tropical region of Central and South America continue to report declining influenza activity. With the exception of Nepal and Sri Lanka, overall transmission continues to decline in most parts of South and Southeast Asia. WHO

According to the Robert Koch Institute for infectious diseases, laboratory confirmed cases of H1N1 flu infection in Germany have more than doubled in the past week, to more than 15,000 reported new cases. As of November 14th, 16 people had died from the flu in Germany, with more than 50,000 infected. ABC News

Spain and Greece launched vaccination campaigns against H1N1 on November 16th. Spain's health ministry said the government has bought 37 million doses of the vaccine and will vaccinate pregnant women, health workers and those with serious illnesses. Health authorities in Greece said a total of 700,000 doses would be made available on a voluntary basis to doctors, ambulance staff, and other high-risk employees. AFP

A young woman was diagnosed with Guillain-Barre Syndrome (GBS), possibly linked to the vaccine being used protect the French public against H1N1 flu. GBS is a rare disease that could lead to death if severe pulmonary complications and nervous system problems are present. Every year, about 1,700 cases of the disease are diagnosed in France. Health Minister Roselyne Bachelot said the case diagnosed was light and that the woman was recovering. Earth Times

Global's H1N1 Update - 11/12/09

The next update will be on Tuesday, November 17th, 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 November 1st, 2009

Vaccine News

The Winnipeg Regional Health Authority confirmed that its H1N1 immunization clinics will remain closed until Nov. 11th. Winnipeg Sun

Some clinics in Manitoba and New Brunswick have temporarily closed due to vaccine shortages. Only 436,000 doses were shipped to the provinces and territories last week, far less than the roughly two million anticipated. Canadian Press

British Columbia's Provincial Health Officer said closures of clinics could be imminent as the province drains the rest of its vaccine supply. Some B.C. clinics are only vaccinating pregnant women while others are also open to children from 6 months to five years. Canadian Press

The Ontario government is expanding its vaccine list to 120 members of the Ontario health ministry actively involved in the pandemic response, first responders, including firefighters, police officers, frontline workers at correctional facilities and youth facility workers and adults aged 65 years or older who live in long-term care homes. CBC

However, clinics in some areas of Ontario are shutting down due to vaccine shortage. Inexplicably, in northern Ontario, clinics are being opened to the general public because they have more vaccine than needed for priority groups. Canadian Press

From Nov. 11th, Alberta Health Services will begin offering H1N1 vaccine to people with chronic conditions, aged 55 to 64 as of Nov. 1; people with chronic conditions, aged 5 to 17 as of Nov. 1. On Nov. 12th, immunization groups will expand further to include people with chronic conditions, aged 45 to 54. Edmonton Journal

While the Harper government has applauded GlaxoSmithKline Inc. for making more than 6 million doses so far, federal officials have commented that Canada needs more than one vaccine manufacturer to deal with future flu pandemics and to avoid production delays that have affected the fight against the H1N1 virus. Had that been the case this time, one manufacturer could have worked on producing adjuvanted vaccine, while the other one could have produced non-adjuvanted vaccines for pregnant women. Initially, officials feared a global flu outbreak would prompt countries with vaccine plants to close their borders and hoard supplies, leading to the desire for vaccines produced in Canada. Globe and Mail

As Canadians line up for dwindling supplies of H1N1 vaccine, Afghan detainees in Canadian custody will have doses made available to them with the same priority as soldiers. Detainees being held at Kandahar Airfield will have the opportunity to be vaccinated from November 11th. Task Force Kandahar's medical staff recently sought legal advice on whether they should be offering the H1N1 flu vaccine to Afghans suspected of Taliban involvement who are being held by Canadians and were told that under Geneva Conventions, prisoners of war should receive the same treatment as Canadian soldiers. Canadian Press

National News

Eight people have died and 202 B.C. residents have been hospitalized with H1N1 flu in the past week, bringing the total number of deaths to 23. The provincial government says three deaths were in the Vancouver Coastal Health region, two were in Fraser and three were in the Vancouver Island region. In total, there have been 601 severe H1N1 cases in B.C. since April. Vancouver Sun

The H1N1 pandemic will help erase 20 per cent of profits across six industries in 2009, according to a study released by the Conference Board of Canada and the Business Development Bank of Canada. One of the obvious drop-offs will be international and national air travel to Canada, hurting the tourism industry. The report noted that H1N1 could have "significant consequences" for the food services industry. It also said that bans on Canadian pork imposed by Venezuela, Russia and China "limit the opportunities for export growth" in a sector already hit by the rising price of the Canadian dollar. The Star

During a virtual summit on First Nations and H1N1, Canada's national aboriginal leader, Shawn Atleo, is warning that the H1N1 flu sweeping the country is just one of many health crises aboriginal communities will face. A disproportionate number of aboriginals have fallen ill with the virus since it hit in the spring. Atleo suggested their vulnerability stems directly from living conditions on reserves, which are overcrowded, lack clean drinking water and which don't have easy access to medical facilities. According to Health Minister Aglukkaq, by the time the second wave of the pandemic had started, more than 95 per cent of First Nation communities had a pandemic plan in place. First Nations communities are almost always high on priority lists for receiving the H1N1 vaccine. Canadian Press

International News

GlaxoSmithKline (GSK) will donate 50 million doses of pandemic H1N1 vaccine to the World Health Organization (WHO) under an agreement signed at WHO headquarters in Geneva by the WHO Director-General, Dr Margaret Chan, and the Chief Executive Officer of GlaxoSmithKline, Mr. Andrew Witty. GSK expects to prepare the first shipments of vaccine to the WHO by the end of November. The WHO has a list of 95 developing countries that are eligible to receive donated vaccines, and aims to secure enough vaccines to cover 10 percent of the population of these countries. WHO

Despite a serious outbreak of H1N1 flu in neighboring Ukraine, the Polish government is not planning to stock up on H1N1 vaccine until it had been properly tested. According to the Polish prime minister, none of the companies cleared by the European Commission to produce the vaccine have been able to assess its long-term effects. Vaccinations, meanwhile, have already begun in France, Italy, Germany and the Czech Republic. Wirtualna Polska

The toll due to influenza A (H1N1) in India crossed the 500-mark to reach 502 after health authorities in Rajasthan reported as many as 14 deaths in the state in the last one month. Net Indian

Swiss pharmaceutical group Novartis has received approval from the German regulatory authorities for its cell culture-based influenza A 2009 monovalent vaccine, Celtura. Novartis continues to pursue registration in other major countries, including Japan and Switzerland. Celtura is manufactured in Marburg, Germany and is an adjuvanted vaccine for persons six months of age and older. Trading Markets

Four more people have died in South Korea after being infected with the Influenza A virus, raising the death toll from the contagious disease to 52. Among the four was a 25-year-old woman who was not classified as a high risk patient. The disaster relief headquarters, which acts as a control tower for the country's efforts to combat the spread of the disease, was set up last week under the Ministry of Public Administration and Security. Korea Times

Weekly Feature

Check out the number of vaccines already distributed and forecasted to be distributed throughout Canada, province by province from the Public Health Agency of Canada.

Global's H1N1 Update - 11/10/09

The next update will be on Thursday, November 12th, 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 November 1st, 2009

Vaccine News

According to Ontario health officials, the GlaxoSmithKline H1N1 unadjuvanted vaccine that is intended for pregnant women won't be going into arms any time soon because Ottawa has not approved it yet. Pregnant women can still get the Australian-made H1N1 shot that doesn't contain an adjuvant. Canadian Press

Alberta is planning to open targeted H1N1 vaccination clinics to children under age 10 with chronic health conditions, such as diabetes and to parents of infants less than six months of age. Calgary Herald

With over 800,000 doses of H1N1 flu vaccine delivered to people throughout the province, 20% of British Columbia’s population has now been vaccinated. A further 250,000 doses of vaccine will be delivered to the province this week. 250 News

Quebec Health Minister Yves Bolduc credits the creation of special vaccination clinics for the province's success in doling out the vaccine. Bolduc said the province's decision to open special vaccination clinics is largely responsible for helping it distribute more of the H1N1 vaccine than any other province. Quebec had vaccinated more than 800,000 people, compared with only 322,000 in Ontario. CBC

Saskatchewan is expecting to get 65,000 more vaccine doses from the manufacturer and has started vaccinating children up to Grade 6. The province is also hoping to expand vaccinations to parents of children under six months of age, people with suppressed immune systems, and those under 35 with underlying health conditions. News Talk CJME

Nova Scotians 19 years of age or younger and who have chronic medical conditions, along with mothers who have just given birth, are now eligible to receive the H1N1 vaccine. The partner of each mother is also eligible for a shot. Canadian Press

Canada's ambassador to Afghanistan is warning that the war-torn country won't be able to rely on Ottawa for extra supplies of H1N1 vaccine. A domestic shortage of the pandemic vaccine makes it unlikely that Canada will be able to send any extra doses overseas. Canadian officials are working to find other ways to slow the spread of H1N1 flu in Afghanistan, which has recently called on foreign countries to provide vaccine. Canadian Press

H1N1 flu vaccine for uniformed service members has arrived at the U.S. Army Medical Material Center, Europe in Pirmasens, Germany. Army health clinics will begin vaccinations as soon as they receive supplies. Distribution to large U.S. Military Treatment Facilities will begin November 9th. Vaccine is expected to arrive at smaller outlying clinics by Nov. 10. United States European Command

France is the latest country to embark on a national H1N1 flu vaccination effort. The program currently targets people in high risk groups such as pregnant women and health care workers. School-aged children will be able to get the pandemic shot starting November 25th. The government said it hopes to immunize about six million people through the program. Canadian Press

National News

Alberta Health has reported five more deaths linked to H1N1 influenza. The provincial health department said that brings the total number of Alberta deaths related to the virus to 25 since the new strain of flu first appeared in the spring. Public health representatives have also said the second wave of H1N1 had not yet hit its peak in Alberta and more deaths from the virus are likely. Calgary Herald

Alberta police are warning the public about scam artists playing on public worry surrounding the H1N1 virus. Some of the alleged H1N1 remedies appearing on the Internet include protective shampoos, nasal sprays, ultraviolet light machines, air sterilizers, and even a pill that claims to cure a H1N1 flu infection within hours. So far only three products have been authorized by Health Canada that should be used against the H1N1 virus — the vaccine Arepanrix, and the antiviral drugs Tamiflu and Relenza. Edmonton Sun

According to reports, the top 200 donors at Montreal's Jewish General Hospital have already been inoculated against the H1N1 virus. Also, board members of Toronto's Mount Sinai Hospital were offered H1N1 flu shots at a regularly scheduled board of governors meeting October 26th. The Ontario union, representing over 46,000 health care workers, has urged all 65 of Mount Sinai's board members, who received their vaccinations on October 26th, to resign. Canwest News Service

International News

The American government has ordered, on an emergency basis, 10,000 treatment courses of peramivir for its national stockpile. Peramivir is given intravenously, making it usable by hospitalized patients who are too ill to take Tamiflu, which is typically given as a pill or Relenza from GlaxoSmithKline, which is inhaled. On October 23rd, the Federal Drug Administration had granted emergency use authorization for the drug to be used in emergencies for patients hospitalized with H1N1 flu. New York Times

British drug maker GlaxoSmithKline is currently Saudi Arabia's sole supplier of an H1N1 flu vaccine. Saudi Arabia's vaccination campaign was launched on November 7th and will first focus on pilgrims and health workers. Reuters

Slovakia has closed all but one road border crossing with Ukraine on November 8th because of Ukraine's flu epidemic. The EU member state's decision was temporary and aimed to protect the bloc. Doctors and hygienists will be stationed at the border to monitor passengers and have the powers to bar anyone suspected of being infected from entering the country. Reuters

A potentially devastating outbreak of H1N1 flu among the Yanomami Indians in Venezuela's Amazon rain forest appears to be contained for now after a rapid medical response in the remote zone. Symptoms of H1N1 flu showed up in more than 1,000 Yanomami according to local health officials said. Medics have given the flu drug Tamiflu to more than 2,000 villagers in the tribal area, which is accessible only by river or aircraft. Reuters

South Korea will provide US$50,000 worth of flu masks to Ukraine, which has seen a large number of influenza-related deaths believed to be linked with the H1N1 virus. The provision of flu masks comes as Kiev has recently asked the World Health Organization (WHO) and other international agencies for emergency aid to relieve the spread of the H1N1 virus. Yonhap News

Weekly Feature

Check out the number of vaccines already distributed and forecasted to be distributed throughout Canada, province by province from the Public Health Agency of Canada.

Global's H1N1 Update - 11/05/09

The next update will be on Tuesday, November 10th, 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 25th, 2009

Vaccine News

In Alberta, H1N1 flu vaccine clinics will be restricted to children between six months and five years old and pregnant women. The vaccine will not be available to other at-risk Albertans, including people under 65 with asthma, diabetes or other chronic health conditions, until more doses are available. Vancouver Sun

The Winnipeg Regional Health Authority decided to expand its vaccine priority list to children aged six months to five years, disadvantaged people, single parents or anyone solely responsible for a dependant and pregnant women. CBC

Saskatchewan's H1N1 flu vaccination program will expand to schoolchildren from kindergarten to Grade 6, women at least 20 weeks pregnant and women who have recently given birth. CBC

In a bid to bring order to the H1N1 vaccination process, end long lineups, and dispel fears of a shortage, public health officials in Quebec will start handing out coupons to those eligible to receive the vaccine. The number of coupons handed out each day will correspond to the number of doses of vaccine available that day. The Gazette

Pregnant women in Ottawa will be able to get unadjuvanted H1N1 vaccine at the city's five fixed vaccination-clinic sites from Nov. 5th, but likely not at the smaller number of roving clinics. Officials are also considering a standalone clinic for pregnant women only to get the unadjuvanted vaccine. Ottawa Citizen

A staff member has been fired after an Alberta Health Services probe into why some members of the Calgary Flames and their families received their own flu shot clinic while other Albertans waited for hours in the cold at other sites. According to an Alberta Health Board statement, disciplinary action has been taken, resulting in the dismissal today of the most senior staff member involved. CBC

Bulk shipments of the main component of the H1N1 vaccine made at a Quebec plant are being exported to other countries. GlaxoSmithKline, which has the sole contract to supply Canada's flu vaccine, says it can produce more antigen than it can expeditiously put into vials for Canadians, and has been exporting excess amounts overseas. Canada’s chief public health officer, Dr. David Butler-Jones, reassured Canadians that the country has first access to all vaccine filled and packaged at the Quebec facility. Vaccine is produced in three stages: bulk production and the formulation of the antigen, filling the vials; and quality control and packaging. Globe and Mail

National News

The House of Commons will debate the H1N1 flu pandemic for the second time as the Liberals are putting forward an opposition motion calling for increased resources for responding to the outbreak. The motion states: "The Government of Canada should therefore immediately: (a) allocate the full $400 million set aside for pandemic response in the 2006 budget to support additional medical staff for vaccinations and patient care; (b) increase support for emergency planning to help local health authorities cope with long line-ups and shortages of both vaccines and health care workers; and (c) divert the money now being spent on needless, partisan advertising of government budgetary measures to a new public awareness campaign to keep Canadians informed with essential up-to-date information throughout the pandemic.” The Star

As the government struggles to efficiently distribute vaccine in the midst of an H1N1 flu outbreak, the federal agency responsible for dealing with various emergencies, including pandemics, has been criticized by Auditor General Sheila Fraser. This finding comes as public anger grows over the delayed rollout of the H1N1 vaccine. According to the report, Public Safety Canada has taken the first step by developing the interim Federal Emergency Response Plan, which has not been formally approved by the government. The plan also does not include updated definitions of the roles, responsibilities, and capabilities needed for an integrated, coordinated approach to emergency response. City News

International News

South Korea's health authorities reported three additional deaths related to the A/H1N1 influenza virus, pulling up the nation's death toll to 45. With nearly 10,000 people found to be infected with the virus per day, South Korea decided to raise its alert level against the A/H1N1 influenza from the second-highest to the top level of "red." China View

According to the American Veterinary Medical Association, a cat in Iowa has tested positive for H1N1 flu, the first time a cat has been diagnosed with the new pandemic strain. The 13-year-old cat apparently caught the virus from one of the people living in the house. It has recovered and does not appear to have infected anyone or anything else. Reuters

Germany is experiencing a new wave of the H1N1 flu virus according to the Robert Koch Institute for infectious diseases. Latest figures show the number of new infections recorded rising to about 3,000 a week as compared to about 1,860 previously. So far, six people in Germany have died of H1N1 and 30,000 have been ill with it. Germany recorded its first known death from the pandemic version of the H1N1 virus, on October 8, and has just begun a public vaccination program. Reuters

In New York, middle and high school students can receive free H1N1 vaccinations at weekend clinics throughout the city by November, 7th. Over the next five weekends, the city will open 29 clinics in an effort to make the vaccine available to every school-age New Yorker. Each clinic would be able to accommodate 500 people per hour. Students must bring signed parental consent forms, which are available online or in person at the clinics. New York Times

The U.S. Department of Agriculture announced recently that pigs in a commercial herd in Indiana have tested positive for the H1N1 flu, making it the first time the virus has been found in such hogs. USDA officials have stressed repeatedly that instances of pigs with H1N1 flu do not pose a threat to consumers of pork products. Still, word of a commercial herd contracting the virus for the first time is bad news for the pork industry, which has struggled with poor prices blamed on H1N1 flu fears and the global recession. Associated Press

Weekly Feature

Check out the number of vaccines already distributed and forecasted to be distributed throughout Canada, province by province from the Public Health Agency of Canada.

Global's H1N1 Update - 11/03/09

The next update will be on Thursday, November 5rd, 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 25th, 2009

Vaccine News

Ontario Health Minister Deb Matthews said residents eligible for the H1N1 shot are experiencing shorter lineups. The number of clinics across Ontario has doubled from 50 to 100. Canadian Press

In Alberta, Health Minister Ron Liepert was called to an emergency meeting with Premier Ed Stelmach and the province's chief health officer after Alberta was forced to suspend its immunization clinics over the weekend due to a shortage of vaccine. Canadian Press

Dwindling supplies also forced temporary suspensions in parts of Manitoba, where the opposition accused the NDP government of creating chaos and public confusion. Canadian Press

Clinics continued to operate in Nova Scotia, but the province has already administered half the doses it received from national suppliers and is only expecting 12,500 this week. Canadian Press

British Columbia has extended the eligibility list for the H1N1 virus to children under five, health care workers and those who take care of infants. By the end of the week, the province will have shipped out 800,000 doses of the vaccine. CBC

The Strategic Advisory Group of Experts (SAGE) on Immunization, which advises the WHO on policies and strategies for vaccines and immunization, acknowledged the U.S. CDC recommendation, that live attenuated seasonal and live attenuated pandemic vaccines should not be co-administered. Seasonal and pandemic vaccines can be administered simultaneously, provided both vaccines are inactivated, or one is inactivated and the other is live attenuated. SAGE also noted that studies in experimental animals using live attenuated vaccines and non-adjuvanted or adjuvanted inactivated vaccines found no evidence of harmful effects on fertility, pregnancy, development of the fetus, birthing, or post-natal development. WHO

National News

There will be an emergency debate in Parliament on Ottawa's response to the H1N1 crisis. Conservative officials emphasized in Question Period that Canada is ahead of the rest of the world on a per-capita basis, with six million doses of the vaccine already in circulation. But the Liberals have said that the Conservatives have to take responsibility for failing to deliver all the promised doses to the provinces, which administer the shots. While the federal government does not decide where vaccine shots are administered, opposition MPs chastized private clinics in Toronto and Vancouver that have received doses. Globe and Mail

The Yukon has seen its first death related to the H1N1 influenza virus. A young girl from the territory, who had a chronic medical condition, died Sunday evening in a Vancouver hospital. Tests confirmed the girl had the H1N1 flu virus. CBC

Federal government data show the provinces and territories have used just over one million doses of H1N1 flu drugs from the national antiviral stockpile and family doctors are seeing increased volumes of patients with influenza-like symptoms. According to latest surveillance data from the Public Health Agency of Canada, the country is experiencing "striking" increases in flu activity across the country, particularly in the West. Canada has a national stockpile of 55-million doses of two antiviral medicines, Tamiflu and Relenza. Canwest News Services

International News

The World Health Organization sent a team of experts to Ukraine today to investigate an outbreak of respiratory disease that’s sickened a quarter of a million people and left pharmacies without masks or flu remedies. Ukraine’s government has closed schools and banned public events. Ukraine faces an outbreak of flu-like illness that’s killed at least 67 people and infected 255,000. Bloomberg

Egyptian authorities quarantined 40 British schoolchildren, some as young as 4, when they stepped off a plane at Sharm al-Sheikh International Airport on a school holiday. The incoming passengers were scanned by hidden infrared imaging devices and those with temperatures even slightly above normal were placed into quarantine for a minimum of five days. New York Times

China reported its seventh death from H1N1 flu last week and said there have been 44,981 cases on the mainland since the outbreak began. The country has moved aggressively to vaccinate vulnerable groups, including students and Muslims participating in the hajj to Saudi Arabia. The country manufactures its own H1N1 flu vaccine. New York Times

Afghanistan declared a health emergency today and ordered schools closed for three weeks in an effort to prevent spread of the virus. Health officials also advised against gatherings, such as weddings, in enclosed spaces. New York Times

Antiviral News

H1N1 flu is sickening so many children across the U.S. that federal health officials decided Friday to release the last 234,000 liquid doses of the national stockpile of children’s Tamiflu. Flu has now killed 114 children and teenagers in the United States since April. Since the CDC. began tracking children’s flu deaths five years ago, the highest toll was 88, in the winter of 2007-8. More doses from Roche are not expected to arrive before January. New York Times

Weekly Feature

Check out the number of vaccines already distributed and forecasted to be distributed throughout Canada, province by province from the Public Health Agency of Canada.