Global's H1N1 Update - 1/26/10

The next update will be on Thursday, January 28th, 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 January 17, 2010

National News

Through the current H1N1 and past pandemics, aboriginal populations have historically been more prone to severe illness. However, a new study published by the Canadian Medical Association Journal says that this is not due to any genetic susceptibility. The report examined cases involving Canadian First Nations people, Australian Aboriginals and Torres Strait Islanders. It noted that all three groups share a high vulnerability, yet have no ancestry in common, but “what they do have in common is a history of colonization, combined with historic and continuing social inequities that have led to significant health disparities.” The researchers were looking for factors linking why some people became severely ill from H1N1, while others did not. Canadian Medical Association Journal

International News

The United States, China, and Hungary have each conducted their own separate inquiries to investigate the safety and efficacy of pandemic H1N1 vaccinations. The three reports contain data previously available only to state regulators, and all three recommend vaccination as a safe, effective safeguard against H1N1 proliferation. The studies randomized people to receive either the vaccine or a placebo, and recorded antibody levels and reported side effects to assess vaccination. Approximately 100 million doses of A/H1N1 flu vaccine have been administered worldwide since September 2009. New England Journal of Medicine

The World Health Organization (WHO) has said that charges by some European officials that the pandemic is “fake” are “wrong and irresponsible.” In a statement, the WHO also said cooperation from a range of partners, including the private sector, is needed to conduct essential public health actions and it has safeguards in place to guard against conflicts of interest. In December a Council of Europe group, introduced a resolution asking the council to investigate charges that pharmaceutical companies have pressured countries to waste resources on inefficient immunization campaigns using vaccines that they say haven't been thoroughly tested. CIDRAP

Vaccine News

Reports from the Public Health Agency of Canada show that, in the first two weeks of January, indicators used to determine influenza levels were normal or even below expectations for this time of year. While the H1N1 virus is still the dominant strain, so far the virus hasn't shifted in its composition. “The indications are that it's not doing too much,” said Earl Brown, executive director of the emerging pathogens research at the University of Ottawa. The H1N1 vaccine has been administered to 45 to 50 percent of the population and thousands of Canadians have recovered from infection, which has helped stem the virus’ spread, Brown said. “The immunity in the population is probably quite solid so it's going to be hard for this virus to move around in the population.” Vancouver Sun

Global's H1N1 Update - 1/21/10

The next update will be on Tuesday, January 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 January 10, 2010

National News

As the 2010 Winter Olympics in Vancouver draw near, regional health and security authorities have reviewed their pandemic plans and say they plan for the worst, but believe they are well prepared for the 16-day event. As a result, hospitals and clinics have geared up to accommodate over a quarter of a million patients, and stockpiled vaccine and millions of doses of the antiviral medication Tamiflu. Spokeswoman for the health authority, Anna Marie D'Angelo says they have history on their side: “Let's remember: There was a flu pandemic during the 1968 Olympics and it had no effect whatsoever on the games.” CNN

Federal Health Minister Leona Aglukkaq has announced funding for a national influenza research network focused on pandemic vaccine evaluation. The network was created through a partnership between the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC). The network will coordinate nation-wide public health research in test methodologies for accelerated clinical trials for medications, and the safety and effectiveness of new vaccines. Canadian Institutes of Health Research

International News

The US Centers for Disease Control and Prevention (CDC) has released an updated report on the international H1N1 situation. Based on studies by the World Health Organization (WHO), the CDC has concluded a substantial under-estimation of total cases in the world as most countries base their pandemic surveillance laboratory tests of people with severe illness. Other findings include a general decline in H1N1 transmission and proliferation with exceptions in North Africa, Nepal, and India. CDC

The British Medical Journal has released a report on influenza in the UK. The study, which is consistent with findings in the US, shows a greater number of infections with children, but a higher H1N1-related mortality rate among the elderly. British Medical Journal

Vaccine News

With over 60% of its population vaccinated, demand is still high for the H1N1 vaccine in Prince Edward Island with an average of 450 people per day booking appointments to get their shots. Deputy Chief Health Officer Dr. Lamont Sweet speculated that this may be due to people planning vacations saying, “Many of them are going to the Caribbean, Mexico, southern areas, and flu circulates year-round in the tropical areas.” CBC News

A vaccine additive made by Novartis, and used in its European influenza shots, may boost the body's immune response to a broader range of viruses, U.S. researchers reported on Wednesday. Laboratory tests suggested the adjuvant called MF59 helped the immune system counteract not only the H5N1 virus in an experimental bird flu vaccine, but mutant viruses as well. Adjuvants, often as simple as an oil and water mixture, broaden the body's response to a vaccine, reducing the amount of active ingredient called antigen needed. Reuters

Global's H1N1 Update - 1/19/10

The next update will be on Thursday, January 21st, 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 January 3, 2010

National News

Approximately 1.5 million Canadians missed work due to H1N1 in November of 2009. According to Statistics Canada, that’s a 27% increase from the previous year and about 9% of the nation’s work force. The impact was greater than, but comparable to, the August 2003 power blackout said the data agency. CBC News

International News

The WHO has countered criticism of their handling of the H1N1 pandemic. Dr. Keiji Fukuda, the WHO’s top influenza expert, denied allegations that the agency overhyped the outbreak or was inappropriately influenced by the pharmaceutical industry in declaring the pandemic. "At this point let's not play word games and let's not be indirect about this matter," he said Thursday from Geneva during a media conference, "The world is going through a real pandemic. The description of it as a fake is both wrong and irresponsible." Winnipeg Free Press

The New England Journal of Medicine released a study that suggests steroids might benefit critically ill patients with suspected H1N1 Influenza. In a case series of 13 consecutive patients with severe hypoxia requiring ventilator support and clinical sepsis, combined treatment with antiviral agents and steroids led to significant improvements in organ function within 1 week. New England Journal of Medicine

Vaccine News

The US Centers for Disease Control (CDC) has issued an open letter to the American people advocating continued vigilance in guarding against influenza infection and urging people to seek H1N1 vaccinations: “The H1N1 flu vaccine is safe, effective, and the best way to protect yourself and your family from the H1N1 flu.”The message, which was co-signed by 37 other American medical organizations including the American Medical Association and the American College of Physicians, goes on to say, “Fighting the flu is a shared responsibility. We ask you to join us in this fight to protect yourself and your community by getting the H1N1 flu vaccine.” CDC

Global's H1N1 Update - 1/14/10

The next update will be on Tuesday, January 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 January 3rd, 2010

National News

The Canadian government has stated that Canada is lending, not donating, five million doses of the H1N1 vaccine to Mexico; however, the government remains silent on what it will do with its expected surplus of the pandemic drug. In the meantime, it has said that it will ship five million doses this week to Mexico, where the pandemic first surfaced. Manufacturers will only deliver the bulk of that country's order at the end of this month and Mexico will replenish Canada's supply by the end of March. The Globe and Mail

International News

Five samples from pigs at the Sheung Shui Slaughterhouse last month have tested positive for human H1N1 pandemic influenza at the University of Hong Kong. As a result, the government has launched the Human Swine Influenza (HIS) Vaccination Program that is aimed at those involved in the pig farming and slaughtering trade. The samples that tested positive for the pandemic H1N1 virus were taken from pigs on the Mainland of China. Food Safety News

The Health Ministry in Lower Saxony has reported that GlaxoSmithKline (GSK) agreed to reduce Germany’s order of Pandemrix H1N1 flu vaccine by 133.3 million Euros after health officials decided they need fewer doses. Germany cut its order to 34 million doses from 50 million doses during negotiations with GSK. European governments are cutting orders, and may donate or sell unused vaccines, after medical authorities in November supported a one-dose regimen rather than the two doses recommended as a guideline for government purchases. Safety concerns and lower-than-expected death rates from the virus also dampened demand for shots. Business Week

Doctors are stumped as to how Bermuda's two fatal flu victims contracted the virus, with health officials revealing yesterday that relatives of the pair have not fallen sick. The Department of Health announced on Wednesday that two Bermudians with influenza had died since December 19 with one confirmed as an H1N1 fatality. But officials are refusing to give out any information which could identify the patients including whether the deaths happened on the Island or overseas for fear of causing panic in the community. The Royal Gazette

A recent report has suggested that the spread of H1N1 influenza among Indians appeared to be in control after the virus reached the indigenous Yanomami group in northern Brazil. Despite a rise in flu-like illnesses, neither deaths nor new confirmed cases were detected in Yanomami villages in the Santa Isabel do Rio Negro region, a medical team there said in its report. The team was sent to monitor suspected cases of H1N1 flu in Brazil's Amazonas state after a 10-year-old Indian boy from a village of the Yanomami ethnic group was hospitalized with serious flu symptoms. China View

Vaccine News

Deputy Health Minister Trinh Quan Huan said the Vietnamese Ministry of Health would send an official query to the World Health Organization regarding recent accusations that pharmaceutical industries unduly influenced the WHO in exaggerating the H1N1 flu pandemic. The deputy minister said Vietnam will also ask WHO for advice on how to proceed with flu prevention strategies. The query comes following accusations from the Health Committee of the Parliamentary Assembly of the Council of Europe (PACE) that several major drug firms deliberately exaggerated the seriousness of the H1N1 pandemic to make enormous profits by causing panic to sell vaccines. Saigon Gaia Phong

According to a Clinical Infectious Diseases study, mandatory flu vaccination of staff has been successful at BJC HealthCare, a St. Louis health group with 26,000 workers. After the requirement was set in 2008, 98.4% of workers were vaccinated. Medical exemptions were granted to 1.2% of workers and religious exemptions to 0.3%. Only eight workers were not vaccinated and not exempted. Fewer employees sought medical or religious exemptions than had declined the vaccine the year before. Clin Infect Dis

U.S. federal officials and representatives from some of the nation's biggest health advocacy groups today teamed up to push the importance of pandemic H1N1 vaccination for people who have chronic medical conditions such as asthma, diabetes, and cancer. As part of National Influenza Vaccination Week, the experts spelled out the risks to these groups in a live Web seminar (webinar) hosted by the US Department of Health and Human Services (HHS). Nicole Lurie, MD, HHS assistant secretary for preparedness and response, told webinar participants that though vaccine uptake in children who have underlying conditions is growing, uptake for adults with chronic conditions is lagging. CIDRAP

Sinovac Biotech Ltd., a leading provider of biopharmaceutical products in China, has announced that it has received its fifth purchase order for its H1N1 vaccine from China's Ministry of Industry and Information Technology. Under this purchase order, Sinovac is required to deliver an additional 8.57 million doses of H1N1 vaccine to the Chinese Central Government, of which 2.33 million doses are expected to be delivered before March 15, 2010, and the balance of 6.23 million doses to be stockpiled by the government in Sinovac's warehouse facility. PR News Wire

Antiviral News

BioCryst Pharmaceuticals Inc. has reported that its partner, Japanese company Shionogi & Co. Ltd., has received marketing and manufacturing approval in Japan for the intravenous flu drug peramivir, which treats several strains of the flu, including H1N1. “This first approval of a BioCryst discovered drug is a major step in our journey towards building an enduring and successful biopharmaceutical company," said President and Chief Executive Jon P. Stonehouse. BioCryst has recently signed agreements with partners to distribute peramivir around the globe. The Wall Street Journal

Global's H1N1 Update - 1/12/10

The next update will be on Thursday, January 14th, 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 January 3rd, 2010

National News

The Public Health Agency of Canada has reported that the last two weeks of 2009, influenza activity in Canada remained low with most of the influenza surveillance regions reporting either sporadic or no activity. Only 1.6% of the specimens tested were positive for influenza during the two-week period while the influenza-like illness consultation rate was below or within the expected range for these weeks. The H1N1 strain still accounts for nearly 100% of the positive influenza A sub-typed specimens. Seventy-six hospitalized cases, 22 ICU admissions and 16 deaths were reported for the two week period. PHAC

International News

In its weekly global surveillance update, the WHO said countries in central, eastern, and south eastern Europe, such as Poland, Serbia, Ukraine, and Georgia, are reporting intense virus circulation. Increased activity in North Africa is particularly evident in Egypt. Pandemic flu activity is still widespread with rates of respiratory diseases increasing in parts of South Asia, including northern India, Nepal, and Sri Lanka. Though the pandemic H1N1 strain is still dominant, small numbers of seasonal H3N2 viruses are circulating in northern China. WHO

The U.S. Centers for Disease Control and Prevention (CDC) recently reported that only one state, Alabama, still had widespread pandemic H1N1 influenza activity last week, down from four the week before, and most other flu indicators were down as well. Pandemic activity in the United States has declined steadily since it peaked with widespread cases in 48 states in late October. Seasonal flu viruses have not yet emerged in any numbers to replace the pandemic strain. CDC Flu View

In a new study of how the H1N1 flu virus spreads through commercial air travel, researchers have found that not only can the number of in-flight infections be predicted based on just one passenger carrying the virus, but also that people travelling in economy class are much more likely to become infected than people flying first class. The study, published in the current online edition of the journal BMC Medicine, used mathematical modelling techniques that enabled the researchers to predict in-flight transmission rates. The Globe and Mail

European flu experts have warned that the declining wave of pandemic H1N1 flu is likely to be followed by new, unknown strains of seasonal flu which health authorities must watch carefully to devise protection measures. The European Center for Disease Prevention and Control (ECDC) warned that flu viruses “never stand still” and said governments should not relax H1N1 flu vaccination programs, but remain on guard for possible changes in the virus and new strains. In the current pandemic, new infections of H1N1 flu have fallen sharply in recent weeks and some governments have been left with an oversupply of vaccines ordered to protect their populations against the virus that emerged last March. Reuters

According to the American College Health Association (ACHA), flu activity at colleges continues to decline, mirroring the national pattern in the United States. ACHA said new cases were down 21% from the week before with only one new death reported. The attack rate was 2.7 cases per 10,000 students. The percentage of students who have been vaccinated rose slightly to 8%, with some states reaching 20% with vaccine availability improving. ACHA

Vaccine News

Mongolia has become the first developing country to receive donated doses of H1N1 vaccine from the World Health Organization (WHO). The first 35 countries on the list to receive vaccine should all get supplies within the next month, WHO spokeswoman Nyka Alexander told the Voice of America. Azerbaijan and Afghanistan are expected to receive doses within days. The WHO has received pledges for 190 million doses from 14 countries. VOA

The BBC News has reported that the British government is looking at ways to “offload” millions of doses of H1N1 vaccine because a third wave of cases is deemed unlikely. Options include selling the surplus doses or giving them to poor countries, but a stockpile will be kept. The government bought 60 million doses from GlaxoSmithKline and 30 million from Baxter. So far, 23.9 million doses of GSK vaccine and 5 million doses of Baxter vaccine have been delivered. BBC News

China's Ministry of Health has said that the government will fund free H1N1 flu vaccinations for all children in the country who are less than 3 years old. The central government made the move in anticipation of Lunar New Year celebrations, when millions of people travel to visit relatives. China has vaccinated 51.4 million residents so far. Agence France-Presse

Global's H1N1 Update - 1/7/10

The next update will be on Tuesday, January 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 December 27th, 2009

National News

The Public Health Agency of Canada has reported that low levels of influenza activity are being noted across Canada and all key influenza indicators have declined for at least five consecutive weeks. The influenza-like illness (ILI) consultation rate is below the expected range for this time of the year and only 3.7% of tested specimens were positive for influenza. However, the pandemic H1N1 strain still accounts for nearly 100% of the positive influenza A sub-typed specimens. The number of hospitalized cases, ICU admissions, and deaths reported this week are about half of those reported last week, and approximately one quarter of those reported two weeks ago. FluWatch

International News

The Centers for Disease Control and Prevention (CDC) reported last week that only four US states had widespread flu activity, down from seven the week before. However, outpatient medical visits for flu-like illness, which was at the national baseline the previous week, edged back above that level, reaching 3.2%. Also, deaths due to pneumonia and flu climbed back above the epidemic threshold. There were four flu-related deaths in children, down from nine the previous week. CDC

An autopsy study in Brazil suggests that people who die of H1N1 contract a "rapidly fatal" form of the disease and tend to die of lung injury, although it strikes different people in different ways. In the first study of its kind, researchers in Brazil examined 21 patients aged one to 68 who died in Sao Paulo with confirmed H1N1 infections in July and August. The study reported that all 21 patients "presented a progressive and rapidly fatal form of the disease," the results of which will be published in the January issue of the American Journal of Respiratory and Critical Care Medicine. AFP

The H1N1 strain of flu is rapidly spreading into China's vast countryside and there could be a spike in cases around the Lunar New Year period when millions head back to their home towns. The world's most populous nation has reported 648 deaths to date and has launched a massive vaccination campaign. The government has been especially worried as the country heads into the depths of winter and ahead of the Lunar New Year holiday in February, when millions of people travel back to their home towns, potentially taking flu with them. Times of India

Vaccine News

Last month U.S. government officials delayed National Influenza Vaccination Week to coincide with more plentiful pandemic vaccine, and they recently announced themes for each day of the week, which starts Jan 10. On Jan 11, efforts will focus on the general public and health care workers. The following 2 days will target those at high risk for flu complications, followed by children, pregnant women, and infant caregivers. Jan 14 messages will aim for young adults, and the next day will feature seniors. FLU.gov

The German Ministry of Health has said that Germany aims to accept only half the Pandemrix H1N1 flu vaccine doses it ordered from GlaxoSmithKline because the disease has proven less severe than expected. Deputy Health Minister Hartmut Schubert stated that the order of 50 million doses was based on the expectation that two shots per person would be required, which proved excessive given the progression of the disease. Twenty-five million doses have been deemed sufficient to protect Germany’s population of more than 80 million people. Bloomberg

Vaccine and Bio-Technology Products is the first company in Vietnam to produce commercial batches of H1N1 vaccine ready for testing. Dr. Nguyen Thu Van, director of the vaccine manufacturer, announced the news saying they had used Vero cell technology to develop the vaccine. If the samples pass testing by National Institute for Control of Vaccine and Biologicals the company will start production of 2 million vaccinations a year. Saigon Daily

The Japanese health ministry will conduct an epidemiologic investigation into whether H1N1 influenza vaccinations can increase the death risk for people with serious chronic diseases. The Ministry of Health, Labor and Welfare plans to begin the study next spring amid an increasing number of reports of deaths and serious side effects among the people who have received shots of domestically produced vaccines against the virus. The ministry said post-vaccination deaths have totaled 104; roughly 80 percent of who are people aged 70 or older who had chronic diseases or disorders, while nearly 1,900 cases of side effects had been reported from medical institutions. The Japan Times

Global's H1N1 Update - 1/5/10

The next update will be on Thursday, January 7th, 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 December 31st, 2009

National News

Flu clinics are reopening in Alberta and the province's deputy medical officer of health says there is still demand for swine flu vaccinations. Provincial officials say about one million people in Alberta have been vaccinated so far. Alberta Health Services will offer the shot at public clinics and they will also be available in doctors' offices in the coming days. Winnipeg Free Press

Toronto Public Health will be holding immunization clinics to give a second H1N1 vaccine dose to those who need it for full protection. “All children from six months to less than three years of age, and those with chronic health conditions who are from three to nine years of age, require a second dose of H1N1 vaccine at least 21 days after receiving their first shot,” the city said Monday in a news release. Toronto Public Health reminded people that the flu usually circulates until the spring. CTV

International News

New research from Italy shows having a seasonal flu shot, or even a case of seasonal influenza, appears to “prime” an H1N1 vaccination and potentially make it more effective. The results are somewhat surprising, because seasonal flu shots alone give no protection against H1N1. The study from Novartis, a major vaccine maker, is based on ferrets, not humans. Canada.com

China said Monday it had recorded 659 H1N1 deaths in 2009, nearly all of them in the last two months of the year, and warned that the danger of mass outbreaks still existed in certain areas. In November, renowned medical whistle-blower Zhong Nanshan, who helped expose the scale of the 2003 outbreak of Severe Acute Respiratory Syndrome, said the true H1N1 death count was being covered up. The government responded by ordering more accurate case reporting by officials. AFP

The Public Health Ministry in Thailand has accepted that it made mistakes in its handling of the H1N1 pandemic outbreak, admitting that it failed to deliver a clear message and left people confused about the preventive measures against the virus that claimed 191 lives. When H1N1 hit the country last May, the ministry had consistently told people that the virus was not any more virulent than the seasonal flu. As a result, Thais became complacent and when the ministry reported the first deaths from the new flu, people no longer believed in the recommended preventive measures. The Nation

The Centers for Disease Control and Prevention (CDC) reported last week that only four US states had widespread flu activity, down from seven the week before. However, outpatient medical visits for flu-like illness, which was at the national baseline the previous week, edged back above that level, reaching 3.2%. Also, deaths due to pneumonia and flu climbed back above the epidemic threshold. There were four flu-related deaths in children, down from nine the previous week. CDC

A humanitarian agency said North Korea recently issued a nationwide alert about its apparently worsening outbreak of pandemic H1N1 influenza. The Seoul-based Buddhist aid group, Good Friends, said that North Korean officials declared that novel H1N1 patients should be given priority. The group said the statement was of a type issued only twice before, for war-related casualties in the 1950s and in 2002. South Korea has shipped 500,000 doses of antivirals to the North. Washington Post

Vaccine News

France has cancelled over half the flu vaccines it ordered to combat the H1N1 flu virus, Health Minister Roselyne Bachelot said on Monday, in an effort to head off criticism after reserving too many shots. The government estimated 94 million individual shots were needed, thinking that everyone would need two jabs for immunity against the illness. Doctors now say a single vaccination is sufficient, meaning that France, with a population of some 65 million has a massive oversupply and is already trying to sell on some of the surplus shots it has received. Reuters

The Public Health Agency of Canada (PHAC) is standing by its decision to stockpile and widely distribute antiviral medications, such as Tamiflu, for use against the H1N1 virus, despite an updated review that questions their usefulness. The review assessed 20 trials to see how well antivirals prevented or reduced the symptoms of influenza, its transmission, and complications in healthy adults. The authors questioned the reliability of evidence that the drugs reduce the risk of complications in healthy adults and advised against prescribing them to treat seasonal influenza. CMAJ