Youngest likeliest to be infected, H1N1 flu study confirms

A young woman gets an H1N1 flu vaccine in New York. New data from Mexico, the epicentre of the swine flu pandemic, has confirmed that young people are most at risk of catching the A(H1N1) virus but elderly patients are most at risk of dying from it.

HEALTH|by AFP – New data from Mexico, the epicentre of the swine flu pandemic, has confirmed that young people are most at risk of catching the A(H1N1) virus but elderly patients are most at risk of dying from it.

The study bolsters the belief that the pathogen is not as virulent as first feared but also stresses the need for caution, as a mutation into a more lethal form cannot be ruled out.

Epidemiologists led by Victor Borja-Aburto of the Mexican Institute for Social Security looked at data for 63,479 people who had been treated for flu-like symptoms in public clinics from the start of the scare in April until the end of July.

Of the 6,945 cases confirmed by tests as H1N1, 56 percent occurred among people between 10 and 39 years, an age group with a high risk of contact through social interaction.

There were far fewer cases among older patients, which suggests that people in this age group were exposed in the past to a cousin to swine flu and may have gained some immunity, the author say.

But when analysed for mortality, a “J-shaped curve” revealed a preponderance of deaths among the elderly.

Among patients aged between 60 and 69, the death rate was 5.7 percent, compared with only 0.9 percent among patients aged between 20 and 29 years.

The study adds to several previous analyses which suggest vaccination against seasonal flu provides a partial shield.

It also strengthens warnings that people with chronic underlying disease are especially vulnerable. Individuals in this category increased their risk of death sixfold.

As of November, 1, more than 199 countries had reported lab-confirmed cases of swine flu, according to a toll published by the World Health Organisation (WHO) last Friday. There have been more than 482,300 notified cases and at least 6,071 deaths.

But the real number of swine flu infections is likely to be very much higher as many countries have stopped counting individual cases, says the WHO.

In addition, the count does not include people who have only mild symptoms — or no symptoms at all — and thus do not bother seeing a doctor.

The mortality rate from swine flu has been variously estimated at between 0.2 and 1.23 percent, according to the country or region or social group that is analysed.

At its lower range, this estimate is akin to the death toll from ordinary, so-called seasonal flu, of around 0.1 percent.

But even the highest figure is still only half of that for the 1918 Spanish flu, where the mortality rate is estimated to have been at least 2.5 percent. Tens of millions of people were killed in that event.

“Some researchers believe, with the information available up to now, that the present H1N1 influenza virus will not cause a pandemic on the scale of those during the 20th century,” said the new study, published online on Thursday by The Lancet.

“This pandemic might not be the one we expected; however, the virus is evolving and the threat continues.”

US sick leave policy toughens H1N1 flu fight: senator

A nurse registers people to receive an H1N1 vaccine during a drive thru H1N1 vaccination clinic at Doctor's Medical Center on November 5, in San Pablo, California. Swine flu is causing "an American emergency" as employees who lack paid sick leave go to work despite being ill and spread the disease, US lawmakers were told Tuesday.

|The City & My Life|AFP – H1N1 flu is causing “an American emergency” as employees who lack paid sick leave go to work despite being ill and spread the disease, US lawmakers were told Tuesday.

The A(H1N1) virus “is causing an emergency for workers and families across the country,” Senator Chris Dodd told a Senate subcommittee hearing on paid sick leave in a time of pandemic flu.

The United States is the only developed nation without a national policy on paid sick leave, Dodd said.

Most government workers, including US legislators, have paid sick leave, but since it is not mandatory some 57 million US private sector workers, including many in low-paid jobs and tens of thousands working in school systems, lack the benefit.

For them, contracting the swine flu “means you have a choice: either go into work sick and risk infecting your co-workers or stay home and lose a day’s pay,” Dodd said.

The senator has introduced legislation to give US workers paid sick days if they or a family member come down with swine flu.

As the nation struggles to emerge from a punishing recession and double-digit unemployment, many Americans cannot consider taking unpaid sick leave, said Dodd.

“We’re in the company — and I say this respectfully of these countries — of Lesotho, Liberia, Papua-New Guinea and Swaziland. Those countries and the United States are the five that don’t have paid sick leave,” Dodd said.

“Five nations, four of whom are struggling economies, barely surviving as nation-states, and the richest country in the world,” he told a hearing in the Senate health, education, labor and pensions subcommittee.

A person who goes into work when they have swine flu will infect 10 percent of their co-workers, according to data from the Centers for Disease Control and Prevention (CDC), which has repeatedly urged people to stay at home if they fall ill with flu-like symptoms.

“If paid sick leave had been a reality when this pandemic began, we would be in better shape,” Dodd said.

The A(H1N1) flu has infected as many as 5.7 million people in 48 US states and claimed 672 lives, including at least 129 children, according to CDC data.

One dose of H1N1 vaccine works for pregnant women: US trial

A nurse gives a shot of the H1N1 vaccine to Mandi Russell, who is seven and a half months pregnant, at the Utah County Health Department in October 2009 in Provo, Utah. A single dose of swine flu vaccine produces a robust immune response in pregnant women, one of the groups at higher risk of dying from (A)H1N1 influenza, initial results from US clinical trials have shown.

AFP – A single dose of swine flu vaccine produces a robust immune response in pregnant women, one of the groups at higher risk of dying from (A)H1N1 influenza, initial results from US clinical trials have shown.

“The immune responses seen in these healthy pregnant women are comparable to those seen in healthy adults at the same time point after a single vaccination, and the vaccine has been well tolerated,” Anthony Fauci, director of the National Institute for Allegies and Infectious Diseases, said in a statement.

No safety issues were reported during the trials, which began on September 9 and tested 120 women, all in the second or third trimester of pregnancy.

Twenty-one days after they were given the swine flu vaccine, 92 percent of pregnant women who were given the single 15-microgram dose and 96 percent of expectant mothers who were given one, 30-microgram dose showed a robust immune response, initial results of the ongoing trials showed.

Since the outbreak of the new strain of (A)H1N1 flu emerged in April, at least 100 pregnant women have been hospitalized in intensive care units in the US and at least 28 expectant mothers have died of pandemic swine flu.

Pregnant women have been turned away from flu vaccination clinics organized by state and county health authorities, where vaccine supply has been far outstripped by demand.

Expectant mothers have to have the injectable form of the swine flu vaccine, which is made with killed (A)H1N1 virus, which cannot cause infection.

The vaccine tested on the women did not contain the preservative thimerosal or an immune-boosting substance known as an adjuvant.

The vaccine is also available in the form of a nasal spray, but it is made with live, although greatly weakened, virus and is not advised for pregnant women, children under the age of two and people with chronic health conditions such as asthma.

Obama Declares H1N1 Flu a National Emergency

(Newswires) President Barack Obama has declared the H1N1 (swine) flu outbreak a national emergency.

The White House on Saturday said Obama signed a proclamation that would allow medical officials to bypass certain federal requirements. Officials described the move as similar to a declaration ahead of a hurricane making landfall.

Swine flu is more widespread now than it’s ever been and has resulted in more than 1,000 U.S. deaths so far.

Health authorities say almost 100 children have died from the flu, known as H1N1, and 46 states now have widespread flu activity.

The White House said Obama signed the declaration on Friday evening.

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OCTOBER 24 UPDATE

The declaration that Obama signed late Friday authorized Health and Human Services Secretary Kathleen Sebelius to bypass federal rules so health officials can respond more quickly to the outbreak, which has killed more than 1,000 people in the United States.

The goal is to remove bureaucratic roadblocks and make it easier for sick people to seek treatment and medical providers to provide it immediately. That could mean fewer hurdles involving Medicare, Medicaid or health privacy regulations.

”As a nation, we have prepared at all levels of government, and as individuals and communities, taking unprecedented steps to counter the emerging pandemic,” Obama wrote in the declaration, which the White House announced Saturday.

He said the pandemic keeps evolving, the rates of illness are rising rapidly in many areas and there’s a potential ”to overburden health care resources.”

Because of vaccine production delays, the government has backed off initial, optimistic estimates that as many as 120 million doses would be available by mid-October. As of Wednesday, only 11 million doses had been shipped to health departments, doctor’s offices and other providers, according to the Centers for Disease Control and Prevention officials said.

The government now hopes to have about 50 million doses of swine flu vaccine out by mid-November and 150 million in December.

The flu virus has to be grown in chicken eggs, and the yield hasn’t been as high as was initially hoped, officials explained.

Swine flu is more widespread now than it’s ever been. Health authorities say almost 100 children have died from the flu, known as H1N1, and 46 states now have widespread fluactivity.

Worldwide, more than 5,000 people have reportedly died from swine flu since it emerged this year and developed into a global epidemic, the World Health Organization said Friday. Since most countries have stopped counting individual swine flu cases, the figure is considered an underestimate.

10% of swine flu vaccine supply to be given to less-developed nations

Nine rich countries agreed to share extra swine flu vaccine with less-developed countries on Thursday, just as companies prepared to deliver supplies.

The United States pledged 10 percent of its vaccine supply, joining Australia, Brazil, France, Italy, New Zealand, Norway, Switzerland, and Britain.

The World Health Organization has been working to persuade countries to share their supplies of vaccine against the pandemic. “They own most of the vaccine out there,” WHO’s Dr. Keiji Fukuda told scientists at an Institute of Medicine pandemic influenza meeting this week.

“The single biggest (issue) we have to deal with is disparity.”

Vaccine makers GlaxoSmithKline and Sanofi-Pasteur previously pledged 120 million doses to WHO. Experts estimate that 80 percent of the world’s nearly 7 billion people live in the developing world, with little hope of getting a vaccine.

WHO has been urging countries that pre-ordered vaccine from the 25 or so manufacturers to share some of it.

“Whatever is available to WHO will be made available first to least-developed countries, about 49 countries, with the intention of providing them to vaccinate their healthcare workers,” Fukuda said.

The United States has ordered 195 million doses of H1N1 vaccine from five makers—Glaxo, Sanofi, Australia’s CSL, AstraZeneca’s MedImmune unit and Novartis.

This is not enough to cover 300 million people but the U.S. Centers for Disease Control and Prevention says almost every year influenza vaccines go unused and millions of doses are thrown away.

Countries all expect a bonus with the news that many of the vaccines being made will protect people with a single dose. Most had ordered vaccine with the expectation that two doses would be needed, so the many now have more than anticipated.

“We will have enough vaccine for every American who wants it,” White House spokesman Reid Cherlin said.

The CDC has designated about 160 million people as high-risk, including pregnant women, people with heart disease, asthma or diabetes, healthcare workers and school-aged children.

“We continue to stress that it is most important for those in high-risk populations to receive the vaccine because they are the groups most likely to have the most severe reaction to the disease,” Cherlin said.

European countries agreed to share vaccine this week under a European Commission plan.