WHO: global death toll from swine flu now over 700

[samanthajane13]

By FRANK JORDANS, Associated Press Writer Frank Jordans, Associated Press Writer – 1 hr 5 mins ago

GENEVA – The worldwide death toll from swine flu has doubled in the past month, reaching over 700 since the start of the outbreak last spring, the World Health Organization said Tuesday.

The U.N. health agency also said it is examining how countries can tackle the expected explosion in cases predicted this fall, when students and workers in the northern hemisphere return from summer vacation.

Closing schools can help break the chain of swine flu transmission, though at risk of considerable economic cost, the British medical journal The Lancet reported Tuesday. The study is to be published in next month's edition.

"School closures is one of the mitigation measures that could be considered by countries," WHO spokeswoman Aphaluck Bhatiasevi told reporters in Geneva.

The agency has stressed that although the disease is "unstoppable" in the long term, slowing its spread is important to prevent hospitals being overwhelmed by the sheer number of new cases.

WHO stopped asking governments to report infections last week, saying it was "extremely difficult, if not impossible" for countries with large numbers of cases to keep track of each new one.

But the Stockholm-based European Center for Disease Prevention and Control, ECDC, said Monday there had been over 2,300 new reported cases in 24 hours, taking the global total to almost 140,000. Many more could have gone undetected, since the virus causes only mild illness in most cases that does not require medical treatment.

WHO did not give a breakdown of the deaths Tuesday. But as of last week, the United States reported 263 deaths, Canada reported 45 deaths and Britain had 29. According to WHO's last update on July 6, there were 119 deaths in Mexico.

Yet even Tuesday's figure of 700 deaths may seriously underestimate the true toll, experts say, because not all swine flu cases are being picked up due to testing limitations.

The Lancet paper, written by researchers at London's Imperial College, argues that school closures would allow more time for a vaccine to be produced and administered widely. Estimates for when this might be the case vary from September to the end of the year.

Slowing the pandemic would also limit the burden on national health care systems and reduce the peak in worker absenteeism, the paper argues.

France is among the countries reportedly considering school closures, though decisions would be made on a a case-by-case basis, Le Parisien daily reported Thursday.

France's Education Ministry has already prepared nearly 300 hours of educational programming for radio and television to allow those affected by school closures to follow their lessons, it said.

___

Associated Press writers Bradley S. Klapper in Geneva, Maria Cheng in London and Jenny Barchfield in Paris contributed to this report.


http://news.yahoo.com/s/ap/20090721/ap_on_he_me/un_who_swine_flu

[samanthajane13]

Global health officials mull how to slow swine flu
By FRANK JORDANS, Associated Press Writer Frank Jordans, Associated Press Writer – Tue Jul 21, 5:30 pm ET

GENEVA – Some Muslim countries are advising pregnant women not to attend the hajj pilgrimage. China is quarantining any visitor suspected of having a fever, while priests in New Zealand have been banned from placing Communion wafers on worshippers' tongues.

It's all part of a global effort to slow the spread of swine flu until a vaccine is ready, although experts are divided on whether the measures will work.

Students across Europe may have their summer vacations extended after the World Health Organization said Tuesday that closing schools was one option countries could consider.

Deaths from the H1N1 virus have doubled in the past three weeks, to over 700 from about 330 at the start of July, the agency said.

"We expect to see more cases and deaths in the future," WHO spokeswoman Aphaluck Bhatiasevi told The Associated Press in Geneva.

The agency gave no breakdown, but as of last week, the United States had reported 263 deaths, Canada had 45 and Britain had 29. According to WHO's last update on July 6, there were 119 deaths in Mexico.

Yet even the latest figures may seriously underestimate the true toll because not all swine flu cases are being picked up due to testing limitations.

The race is now on to develop a vaccine that is effective against the pandemic strain before the flu season begins this fall in the northern hemisphere. Estimates for when a vaccine will be available range from September to December.

In the meantime, the U.N. health agency is working with its national counterparts around the world to examine what countries can do.

"School closures is one of the mitigation measures that could be considered by countries," Bhatiasevi told reporters.

Experts have argued that school closures may be among the most effective measures, but warn there may be a considerable economic downside, too.

Religious leaders have been drawn into the debate after authorities in Jordan and health officials at a conference in Saudi Arabia recommended that people thought to be most at risk, including pregnant women and those with chronic diseases, skip the hajj pilgrimage this year.

Arab health ministers are holding an emergency meeting Wednesday in Cairo to come up with a unified plan to confront the pandemic.

In New Zealand, the Roman Catholic Church imposed a ban on priests placing Communion wafers on the tongues of worshippers and on the sharing of Communion wine. It also asked parishioners to avoid bodily contact at services, including shaking hands.

In Chile, where 40 people have died from swine flu, authorities canceled a popular religious festival that normally draws tens of thousands of worshippers to the northern town of La Tirana, prompting protests from the faithful.

"The key question is whether citizens will accept the measures governments impose," said Christian Drosten, head of the Institute for Virology at the University of Bonn in Germany.

"You need to get the population on board, otherwise your efforts won't work," he said. "Once people take the disease seriously, you'll begin to see the kind of social distancing that limits infection."

"But it's all a question of culture," Drosten added. "What works in Europe may not work in other countries, and vice versa."

In Switzerland, supermarket chains are considering requiring customers to disinfect their hands and put on a face mask as they enter the store.

"We can put these measures in place as quickly we get food into the stores," said Urs Peter Naef, a spokesman for the Migros chain, Switzerland's biggest.

China's practice of forcibly quarantining visitors has caused bewilderment elsewhere, particularly when hundreds of American, British and other foreign students have been sealed off in hotels for days on just the suspicion of infection.

Chinese officials in masks or hazmat suits board planes, pointing temperature guns at passengers' foreheads. If a passenger is diagnosed with swine flu, anyone seated within three rows is often tracked down. Those quarantined get to leave if they are healthy seven days from the date they landed.

In Britain, health officials' advice that women put off planning to have children due to the global outbreak was met with ridicule since the swine flu pandemic may last years.

One measure comes up again and again — school closures — but it has its own risks.

A paper published Tuesday in the medical journal The Lancet argues that closing schools can help break the chain of transmission, slowing the pace of the disease and lessening the burden on health care systems.

But the paper, written by researchers at London's Imperial College, also noted the considerable economic costs as parents are forced to stay home to look after their children.

France's Education Ministry has already prepared nearly 300 hours of educational programming for radio and television to allow those affected by school closures to follow their lessons, the Le Parisien daily reported.

The experience of school closures in the United States during the early days of the epidemic may prove to be a guide for how best to handle outbreaks in an educational setting.

Initially, authorities recommended schools close for two weeks if there was a suspected case, but when the virus turned out to be milder than feared they switched to advising parents to keep only sick students home. Schools could still close if there were a large number of student and staff out sick — the same guidance for schools contending with an outbreak of seasonal flu.

"We have some general philosophies and principles that the best place for healthy kids is in school, where they can learn ... and where many of them get breakfast and lunch and can be nourished as well," Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention said last week.

Apart from school closures, a team of WHO experts is also examining other measures including postponing mass gatherings, such as sports events and concerts, Bhatiasevi said. That could prove very unpopular since football and Major League Baseball, as well as world soccer teams all have heavy fall schedules.

Ultimately, the responsibility to decide what to do to keep the pandemic under control rests with individual governments, Bhatiasevi said.

"Different countries could be facing a pandemic at different levels at different times. It is really up to countries to consider what mitigation efforts suit them."

___

Associated Press writers Bradley S. Klapper in Geneva, Jenny Barchfield in Paris, Rebecca Santana in Cairo, Jamal Halaby in Amman, Jordan, Eduardo Gallardo in Santiago, Chile, and AP medical writers Maria Cheng and Stephanie Nano contributed to this report.


http://news.yahoo.com/s/ap/20090721/ap_on_re_eu/un_who_swine_flu

[grneyes]

They were saying on a news break tonight that there is a case/strain here in Canada that is resistant to the antidote. That definitely isn't good news. :(

[samanthajane13]

AP Interview: Flu chief: Pandemic in early stages
By FRANK JORDANS, Associated Press Writer Frank Jordans, Associated Press Writer – 55 mins ago

GENEVA – The global swine flu epidemic is still in its early stages, even though reports of over 100,000 infections in England alone last week are plausible, the World Health Organization's flu chief said Friday,

Keiji Fukuda, WHO's Assistant Director-General for Health Security and Environment, told The Associated Press that given the size of the world's population, the new H1N1 virus is likely to spread for some time.

WHO earlier estimated that as many as 2 billion people could become infected over the next two years.

"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Fukuda said in an interview at WHO's headquarters in Geneva.

The global health agency stopped asking governments to report new cases last week, saying the effort was too great now that the disease has become so widespread in some countries.

Authorities in Britain say there were over 100,000 infections in England alone last week, while U.S. health officials estimate the United States has passed the 1 million case mark. Those figures dwarf WHO's tally of 130,000 confirmed cases worldwide since the start of the outbreak last spring.

"We know that the total number of laboratory confirmed cases is really only a subset of the total number of cases," Fukuda said.

Fukuda, the former chief of epidemiology at the U.S. Centers for Disease Control and Prevention, also said there must be no doubt over the safety of swine flu vaccines before they are given to the public.

Health officials and drug makers are looking into ways of speeding up the production of the vaccine before the northern hemisphere enters its flu season in the fall.

The first vaccines are expected in September and October, said Fukuda. Other vaccines will take until December or January before they are released onto the market — well into flu season when a further dramatic rise in swine flu cases is predicted.

"Everybody involved with the vaccine work, from manufacturers up to the regulatory agencies, are looking at what steps can be taken to make the process as streamlined as possible," Fukuda said. "One of the things which cannot be compromised is the safety of vaccines."

The search for an effective inoculation has taken on a new urgency as WHO announced that almost 800 people have died from the disease in the past four months. This is more than the H5N1 bird flu strain has killed in six years.

One question that scientists and health officials have disagree on is whether pregnant women should be among the first to receive a vaccine.

A report by WHO experts found that pregnant women appear to be "at increased risk for severe disease, potentially resulting in spontaneous abortion and/or death, especially during the second and third trimesters of pregnancy."

Several women and their children have died in recent weeks, though obesity may have played a role in some of the deaths, the report says.

"Pregnant women have emerged as one of the groups that we are concerned about as being at higher risk than other people in terms of having the possibility of developing severe illness," said Fukuda.

But right now, WHO is holding back on recommending that pregnant women receive priority vaccinations. And the agency is not commenting on the contentious suggestion by British and Swiss health officials that women should consider delaying pregnancy if they can.

"WHO certainly has no recommendations on whether women should try to have children" now, Fukuda said.

The agency has been working hard to ensure that poor countries receive vaccines too, despite rich nations having pre-ordered most of the available stock. A WHO spokesman said Friday that two drug makers have pledged to donate 150 million doses of vaccine to poorer countries by the end of October.

"We're working with a range of partners to secure more vaccine for developing countries," WHO's Gregory Hartl said.

Fukuda, who is effectively in charge of WHO's pandemic response until mid-August while the agency's Hong Kong-born Director-General Margaret Chan is on home leave, also addressed the possibility that the virus might mutate and become resistant to anti-viral drugs such as Tamiflu.

Four separate Tamiflu-resistant cases have been reported recently from Denmark, Japan, Hong Kong and Canada.

"We haven't seen widespread emergence of resistance to the drug right now," Fukuda said, but added "this is something we're watching very carefully."

It is inevitable that over a long enough period of time the swine flu virus will mutate, he said.

"Unfortunately we can't predict in what direction," he said.

____

Associated Press Writer Bradley S. Klapper contributed to this report.


http://news.yahoo.com/s/ap/20090724/ap_on_he_me/un_who_swine_flu_chief

[samanthajane13]

Swine flu could strike up to 40 percent in 2 years
By MIKE STOBBE, AP Medical Writer Mike Stobbe, Ap Medical Writer – 31 mins ago

ATLANTA – U.S. health officials say swine flu could strike up to 40 percent of Americans over the next two years and as many as several hundred thousand could die if a vaccine campaign and other measures aren't successful.

Those estimates from the Centers for Disease Control and Prevention mean about twice the number of people who usually get sick in a normal flu season would be struck by swine flu. Officials said those projections would drop if a new vaccine is ready and widely available, as U.S. officials expect.

The U.S. may have as many as 160 million doses of swine flu vaccine available sometime in October, and U.S. tests of the new vaccine are to start shortly, federal officials said this week.

The infection estimates are based on a flu pandemic from 1957, which killed nearly 70,000 in the United States but was not as severe as the infamous Spanish flu pandemic of 1918-19. But influenza is notoriously hard to predict. The number of deaths and illnesses would drop if the pandemic peters out or if efforts to slow its spread are successful, said CDC spokesman Tom Skinner.

A CDC official said the agency came up with the estimate last month, but it was first disclosed in an interview with The Associated Press.

"Hopefully, mitigation efforts will have a big impact on future cases," Skinner said.

In a normal flu season, about 36,000 people die from flu and its complications, according to American Medical Association estimates. Because so many more people are expected to catch the new flu, the number of deaths over two years could range from 90,000 to several hundred thousand, the CDC calculated. Again, that is if a new vaccine and other efforts fail.

First identified in April, swine flu has so far caused about 263 U.S. deaths, according to the latest numbers. CDC officials say it's likely that more than 1 million Americans have become sick from the virus, although many were probably mild cases never reported.

Because the swine flu virus is new, most people haven't developed an immunity against it. So far, most of those who have died from it in the United States have had other health problems, such as asthma.

The virus has caused an unusual number of serious illnesses in teens and young adults; seasonal flu usually is toughest on the elderly and very young children.

New swine flu illness have erupted through the summer, which is also unusual, though cases were less widespread this month. Officials fear an explosion of cases in the fall, when children return to school and the weather turns cold, making the virus easier to spread.


http://news.yahoo.com/s/ap/20090724/ap_on_he_me/us_med_swine_flu

[samanthajane13]

Europe fast-tracking swine flu vaccine
By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer – 30 mins ago

LONDON – In a drive to inoculate people against swine flu before winter, many European governments say they will fast-track the testing of a new flu vaccine, arousing concern among some experts about safety issues and proper vaccine doses.

The European Medicines Agency, the EU's top drug regulatory body, is accelerating the approval process for swine flu vaccine, and countries such as Britain, Greece, France and Sweden say they'll start using the vaccine after it's greenlighted — possibly within weeks.

In an interview with The Associated Press, Dr. Keiji Fukuda, the World Health Organization's flu chief, warned about the potential dangers of untested vaccines, although he stopped short of criticizing Europe's approach outright.

"One of the things which cannot be compromised is the safety of vaccines," he said Friday. "There are certain areas where you can make economies, perhaps, but certain areas where you simply do not try to make any economies."

Flu vaccines have been used for 40 years, and many experts say extensive testing is unnecessary, since the swine flu vaccine will simply contain a new ingredient: the swine flu virus.

But European officials won't know if the new vaccine causes any rare side effects until millions of people get the shots. Still, they say the benefit of saving lives is worth the gamble.

"Everybody is doing the best they can in a situation which is far from ideal," said Martin Harvey-Allchurch, a spokesman for the European Medicines Agency. "With the winter flu season approaching, we need to make sure the vaccine is available."

In Europe, flu vaccines are usually tested on hundreds of people for several weeks or months, to ensure the immune system produces enough antibodies to fight the infection.

But to ensure swine flu vaccine is available as soon as possible, the European Medicines Agency is allowing companies to skip testing in large numbers of people before the vaccine is approved.

The main issue is probably that without thorough testing it's difficult to gauge the effective dosage — meaning Europeans might get too weak a vaccine. It's unlikely the vaccine would endanger anyone, but until it is used in large numbers of people, no one will know for sure.

Europeans appear ready to use the vaccine widely before conducting any big studies to prove it is safe and effective. Neither the vaccine makers nor the European Medicines Agency would specify what basic safety tests are being done.

The U.S. is taking a more cautious approach: the government called Wednesday for several thousand volunteers to be injected with the swine flu vaccine in tests beginning in August to assess the vaccine's safety. American officials said results should be ready by the time the U.S. plans to roll out a vaccination campaign in October.

Results from the U.S. tests will be of limited use to Europe, since countries like Britain plan to start vaccinating as early as August — before any American trial data is available. The vaccines used in the U.S. will also be different from those in Europe.

Some experts favor urgent action.

"The consequences of not having a vaccine if this virus gets worse are very high," said Leonard Marcus, a public health expert at Harvard University. "If (regulatory authorities) took all the time that was necessary to make sure there are no side effects, ironically, in the effort to save a few lives, many lives could be lost."

But critics say dangers lurk in any strategy to vaccinate without robust testing.

Scant information exists on flu vaccines with adjuvants, a component used to stretch the active ingredient that is commonly found in European flu vaccines. There are no licensed flu vaccines with the ingredient in the U.S.

There is also limited or no data on the safety and effectiveness of vaccines with adjuvants in children under 3 and pregnant women — two of the most vulnerable groups in a pandemic — a global outbreak.

Mass swine flu vaccination campaigns will also take place in the shadow of the 1976 swine flu disaster, when hundreds of people in the U.S. developed Guillain-Barre syndrome, a paralyzing disorder, after being vaccinated.

Experts don't know why that happened, but say modern vaccine production techniques have improved since 1976. To avoid a similar episode, some say comprehensive testing before the vaccine is rolled out is essential.

"I can't see any possible excuse to not test it for safety before it's given to anyone," said George Annas, a bioethics expert at Boston University.

If the vaccine turns out to have dangerous side effects, it could generate a public backlash, particularly in a country like Britain, where many people remain suspicious of vaccines because of unsubstantiated allegations linking the measles, mumps and rubella vaccine to autism. That could lead to millions of people refusing vaccination.

When the bird flu crisis hit several years ago, the European Medicines Agency designed a special protocol to approve a vaccine for use in a pandemic as soon as possible.

The agency let companies submit data for a "mock-up" vaccine, using H5N1 bird flu. The idea was to do most of the testing before the global epidemic hit so when it did, drugmakers could insert the pandemic virus into the vaccine at the last minute.

When the first swine flu vaccine doses are ready, the European Medicines Agency will approve them largely based on data from the bird flu vaccine, since both will have the same basic ingredients.

If the agency thinks the bird flu data predicts how the swine flu virus will work, they will approve it, said spokesman Harvey-Allchurch.

The agency will then require regular reporting of the vaccine's effects as it is being administered — monitoring that is normally done beforehand.

WHO's Fukuda said everyone involved in making the vaccine, from manufacturers to regulatory agencies, is looking at what steps can be taken to streamline the process.

"But there is no one who disagrees that one of the absolutes is that there can't be any question whether the vaccine is safe or not," he said.

WHO reported that the swine flu viruses aren't producing enough of a key vaccine ingredient, which may limit how much vaccine is available. Its laboratory network is now working to produce a new set of viruses that it hopes will work better.

Drugmakers including Baxter International, GlaxoSmithKline PLC, Novartis and Sanofi-Pasteur, however, insist they will be able to start shipping the first batches of vaccine soon.

British health officials have repeatedly said they will start vaccinating in August, as soon as the vaccine is approved. Other European countries, including Greece, France, Sweden, say they will use the vaccine after it gets the green light from the European agency, but none other than Britain expect to start the shots next month.

___

Associated Press writers Frank Jordans in Geneva, Malin Rising in Stockholm, Jenny Barchfield in Paris, and Derek Gatopoulos in Athens contributed to this report.


http://news.yahoo.com/s/ap/20090726/ap_on_he_me/eu_med_swine_flu_vaccine_fast_track