Global's H1N1 Update - 04/29/10

The next update will be on Tuesday, May 4th, 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 April 4, 2010

International News

Australia's Therapeutic Goods Administration has widened its probe into CSL's seasonal flu vaccine, which includes the pandemic strain, after children receiving the shot had fevers and convulsions. The agency asked all states and territories to examine all reports of fever in children under 5 for evidence of any pattern. Also, New Zealand reported today that five children experienced convulsions after flu vaccinations, according to news reports in that country. Bloomberg

Researchers found that the commonly used CDC case definition may not work for detecting mild pandemic H1N1 flu. They reviewed medical records of 44 patients with lab-confirmed H1N1 who were hospitalized in early summer 2009 and found that many of them had no fever. They found cough to be a more sensitive H1N1 indicator. The authors conclude that “the standard case definition for 2009 H1N1 influenza has low sensitivity for mild influenza infection.” American Journal of Infection Control

Global's H1N1 Update - 04/27/10

The next update will be on Thursday, April 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 April 4, 2010

National News

Overall influenza activity has continued to be low for at least 17 consecutive weeks. Only one specimen (out of 1,379) tested positive for pandemic H1N1 2009 in the third week of April. No new H1N1-related hospitalizations and deaths have been reported this week. To date, only 14 hospitalizations and two deaths have occurred across Canada since the beginning of 2010. As of week 14, influenza activity level in the Southern Hemisphere continues to be low in general. Of note, however, in Chile, there was evidence of early localized pandemic influenza virus transmission in advance of the usual start of the southern hemisphere winter influenza season. PHAC FluWatch

International News

Australian Broadcasting Corporation (ABC) has reported that the number of children in West Australia who had convulsions or fever and vomiting after receiving a seasonal flu vaccine that covers the pandemic strain has grown to 251. Officials say the immunizations likely came from multiple batches. Queensland is also investigating the possibility of adverse reactions in children, and police in Brisbane are probing the death of a recently vaccinated 2-year-old, according to other ABC reports. ABC

Global's H1N1 Update - 04/22/10

The next update will be on Thursday, April 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 April 4, 2010

International News

After a quiet start to the year, Bangladesh is reporting rapid spread of pandemic flu this month and has placed health officials across the country on alert. “The virus sustained at a lower level in Bangladesh during January-March period, but it showed rising trend since the beginning of this month,” a health official said, adding that April through September is typically the busiest season for flu. He did not specify case numbers. Balita

Nigeria has yet to receive any H1N1 pandemic vaccine and is concerned that cases may grow as nearby Ghana is reporting an outbreak. Nigeria has confirmed 11 cases and 2 pandemic deaths. The story quoted unnamed experts as saying global demand for the vaccine has outpaced supply, making it difficult for developing countries to obtain doses. Nigeria Bulletin

In the biggest and most detailed look yet at pandemic flu infections in pregnant women, researchers from the US Centers for Disease Control and Prevention (CDC) have reported that early antiviral treatment was linked to fewer intensive care unit (ICU) admissions and that severe illnesses and deaths are more likely to occur during the third trimester. The CDC researchers, along with a Pandemic H1N1 Influenza in Pregnancy Working Group made up of health officials from several U.S. states, based their findings on reports of pregnant women who were sick with pandemic H1N1 infections through August plus more recent reports of women who were admitted to ICUs. The findings appear in the Apr 21 issue of the Journal of the American Medical Association (JAMA). CIDRAP

Global's H1N1 Update - 04/20/10

The next update will be on Tuesday, April 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), as of April 4, 2010

National News

Canadian researchers have reported that patients who became severely ill with H1N1 swine flu last year often developed kidney failure, which worsened their illness and raised costs. Doctors should be on the lookout for kidney damage in patients who are hospitalized with the virus, they told a meeting of the National Kidney Foundation. “It's concerning that so many people got some form of kidney injury, although it was reversible in the majority of them,” Dr. Manish Sood of the University of Manitoba in Winnipeg said in a statement. Sood's team looked at the cases of 47 critically ill patients with confirmed H1N1 infections who were admitted to one of seven intensive care units in Manitoba. National Post

International News

Just weeks before it hosts the World Cup, South Africa is reporting a shortage of H1N1 vaccine. Doctors and pharmacies have run out of the vaccine, imported from Australia, and say no more is available. The country received 1.3 million doses, which are being used for "front line" port-of-entry workers and certain HIV patients. A further 3.5 million doses donated by the World Health Organization (WHO) will be used on pregnant women and others at high risk. West Cape News

Health officials in Chile are concerned that only 600,000 of a hoped-for 4 million people have received the H1N1 vaccine in a country that saw 300,000 cases and 1,800 hospitalizations last year. And this year a Feb 27 earthquake destroyed 5,000 hospital beds in the central region. One university faculty member explained that getting the shot early is essential to prevent overloading of hospitals, because immunity takes about 2 weeks to build. Santiago Times

Global's H1N1 Update - 04/15/10

The next update will be on Tuesday, April 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 April 4, 2010

National News

The premature expiry of a batch of adjuvanted H1N1 vaccine has prompted the Alberta government to ask manufacturer GlaxoSmithKline for a refund. The vaccines were supposed to last for 18 months, based on scientific evidence at the time; however, Health Canada has announced a new expiry date of only six months, after tests found the vaccine's potency declined after that time period. Alberta has around 650,000 to 700,000 doses of the affected vaccine, worth $2.2 million. CBC

International News

U.S. researchers recently presented a study at the American Academy of Neurology’s annual meeting that showed reports of Guillain-Barré Syndrome associated with H1N1 vaccination in the U.S. were extremely low. For every 10 million H1N1 vaccinations administered in the U.S. last year, officials received about six reports of people developing Guillain-Barré Syndrome, a rare neurological disorder. But memories of problems during a 1976 immunization campaign and public anxiety during last year’s H1N1 pandemic stoked fears that mass inoculation using a new vaccine would result in a rash of serious side effects, health problems and even deaths. Now that the peak of the pandemic has passed and researchers are looking back at the response, signs indicate many of those public fears were exaggerated, or even unfounded. Globe and Mail

The American College Health Association (ACHA) has said that flu activity at U.S. colleges has dropped to its lowest level since August when surveillance began. The increases seen in southeastern states in February and March are also easing. The attack rate last week was 1 case per 10,000 students, a decrease of 38% from the previous week. No hospitalizations or deaths were reported, and the ACHA saw no evidence of sustained transmission. Vaccine uptake held at 8%, where it has been for several weeks. ACHA

A laboratory in Namibia recently confirmed the country's first pandemic H1N1 case, a patient who had traveled with a group to Thailand. The illness is also suspected in a second patient who was with the group. Namibia's health minister expressed disappointment that the finding was first reported in the media before the case was reported to health officials. The country expects to launch its vaccine campaign in May with 220,000 doses from the WHO. Nambian

Global's H1N1 Update - 04/13/10

The next update will be on Thursday, April 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 April 4, 2010


National News

Adjuvant vaccines set to expire sooner than expected

The Public Health Agency of Canada has moved up the expiry dates for H1N1 vaccines containing adjuvant, effectively shortening their shelf lives. In an e-mail to reporters, the agency said, “In early March 2010, Health Canada, after careful analysis of both GSK [GlaxoSmithKline, the vaccine’s manufacturer] and its own stability data, determined that the 18 month shelf life was no longer appropriate for the product.” Unused vaccines will now have a recommended shelf life of six months. The department has said that the expiry date revision is not safety related, and to date Canadians who have received vaccines using adjuvant have been provided with sufficient immune response against H1N1 infection. CBC News

International News

WHO admits to flaws in its response to H1N1

The World Health Organization (WHO) has conceded shortcomings in its handling of public information during the H1N1 outbreak. Critics have said the organization created a panic in declaring a pandemic and question links with pharmaceutical companies that recorded large profits from producing vaccines. Addressing the first meeting of the external review committee of the WHO’s pandemic response, Dr. Keiji Fukuda, the agency’s top influenza expert said, “We have a great deal of speculation, we have a great deal of criticism […] I think we did not convey the uncertainty [inherent in a pandemic]. That was interpreted by many as a non-transparent process.”

Still, the agency does not regret making the declaration. "We have always been very clear that based on the virologic information, based on the immunologic information, the epidemiologic information, the differences in clinical patterns that we see from seasonal influenza, we have never had a moment's doubt of whether this is a pandemic or not," he said.

Dr. Fukuda went on to describe the confusion around the WHO’s six-phase system for declaring a pandemic as “vexing.” H1N1 was ultimately not as deadly as the widely-feared avian influenza, but the organization’s scale only accounts for the geographic spread of a virus, not its severity. The WHO tried to come up with a standard for measuring the pandemic's severity using death rates, but many countries lack the ability to gather sufficient levels of information or even basic birth and death registries. "Many countries don't have the actual capacity to determine reliably the severity of the virus," said Dr. Martin Cetron one of the experts from the U.S. Centers for Disease Control and Prevention taking part in the review. The Vancouver Sun

Global's H1N1 Update - 04/08/10

The next update will be on Tuesday, April 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 March 28, 2010

National News

Even with peer review a controversial H1N1 study may raise more questions than it answers
A series of controversial Canadian studies have been published in the top-flight Public Library of Science Medical Journal causing some who dismissed the research to rethink their skepticism. The studies indicate a person’s chances of contracting pandemic H1N1 double if they first receive a shot for seasonal influenza. Researchers made their findings known in the spring of 2009 prompting a scramble among health authorities as they struggled to revise their vaccination programs, most postponing them altogether until the pandemic vaccine was available.

Outside Canada the effect was not detected, so the findings were dismissed as troubling but unconfirmed. The authors of the report remain proponents of flu shots saying the phenomenon really only relates to a brief period of time when humans were first exposed to the virus. Dr. Ed Belongia, the director of epidemiology at the Marshfield Clinic Research Institute in Marshfield, Wisconsin says that while his centre's findings do not corroborate the Canadian studies, he’s impressed with their level of scrutiny and, “in that sense I can't easily dismiss it.” CBC News


Universal vaccination program saves both money and lives
Unlike most other provinces, Ontario has offered a universal flu vaccination program since 2000. Free flu shots are more commonly offered only to seniors and those who are at higher risk of flu-related complications. A University of Toronto study has found that Ontario’s program routinely saves at least 100 lives and prevents 35 000 more from falling ill each year. Even though it is $20 million more expensive than other plans, the projected cost of administering those escalated cases means the program still saves the Ontario health care system about $7.8 million. CanWest News Service

The next update will be on Thursday, April 8th, 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 March 28, 2010

National News

Federal government wants to analyze the impact of travel on pandemics

The Public Health Agency of Canada is commissioning a study to find out if travel advisories had any effect on when and where people traveled during the H1N1 outbreak and whether or not it resulted in any change in how the diseased was spread. Dr. Mark Lysyshyn at the agency’s Centre for Emergency Preparedness hopes the findings will give insight into the timing of advisories and which airports should be more closely watched. “We may not be able to prevent a pandemic coming to Canada, but we would like the epidemic curve to rise very slowly… it kind of trickles into Canada as opposed to coming in like a waterfall.” The Toronto Star

International News

Australia looks to the future of pandemic response

An editorial has been published in the Medical Journal of Australia that takes a look beyond the H1N1 pandemic and examines some of the lessons to be learned in preparing for future outbreaks. Among other things, the article calls for a review of the use of the term pandemic in consideration of its connotations in the public’s consciousness, and questions the usefulness of antiviral drugs like oseltamivir in slowing the overall spread of the pandemic. Medical Journal of Australia

Global's H1N1 Update - 04/01/10

The next update will be on Tuesday, April 6^th, 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 March 21, 2010

National News

Nova Scotia pharmacists take on vaccination duties

Health officials in Nova Scotia are preparing an amendment to the province’s Pharmacy Act to allow pharmacists to administer injections in their scope of practice. The move is aimed at relieving some of the workload from Nova Scotia doctors and enabling them to focus on other areas of care. The provincial Health Minister wouldn’t say for certain whether the change would mean user-fees might be charged for the shots. With the support of Doctors Nova Scotia, the Nova Scotia College of Pharmacists has added administering injections to their accreditation curriculum. Currently, pharmacists are training and taking on the new duties on a voluntary basis. Over time, the practice will become the norm. Winnipeg Free Press

International News

Researchers discover avian immunity gene

A research team headquartered at the University of Alberta has isolated a gene that allows ducks’ immune systems to contain the influenza virus without falling ill. Chickens, which lack the gene, can die within 18 hours of infection, but scientists have found a way to transfer the trait from duck to chicken cells and reduce viral replication within chickens by half. The discovery could lead to a breed of H5N1-resistant chickens and suppress the avian flu’s ability spread amongst birds. The Times of India