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Swine flu vaccines delayed as US deaths climb

Brace to be 'overwhelmed' by swine flu: WHO official
The northern hemisphere should brace for a tough fight against swine flu, which "overwhelmed" hospitals in the southern hemisphere, a world flu expert said Friday. Data presented at a three-day meeting of health professionals here showed that "this virus causes severe pneumonia compared to seasonal flu," World Health Organization (WHO) influenza expert Nikki Shindo told reporters.

The influenza A(H1N1) virus, she warned, can cause potentially life-threatening viral pneumonia far more often than the seasonal flu. "This virus really likes the lower respiratory tract, which means this virus is more likely to cause viral pneumonia than seasonal pneumonia," Shindo warned. "Of course, we don't have pre-existing immunity. Therefore, we can expect more severe disease and hospitalization during the upcoming influenza season."

Doctors from southern hemisphere countries told the meeting that swine flu had "overwhelmed emergency rooms and especially intensive care units because of the very severe patients who required special care," Shindo said. Around 30 percent of severe cases had bacterial co-infections, she added, urging that anti-viral treatments be administered in a timely fashion to reduce severe disease. The antiviral drugs Tamiflu and Relenza have been shown to be effective in treating the novel flu virus, which has killed at least 4,735 people since it was first reported in April in Mexico, according to a WHO tally. "Clinicians sometimes tend to wait to get laboratory confirmation of H1N1 infection and this causes an unfortunate delay in treatment," said Shindo.

"They have to decide on care based on epidemiological information and patient observation," Shindo said, noting that severe progressive cases in previously healthy adults tend to deteriorate from the third day of the onset of illness. The Washington meeting gathered scores of pathologists, virologists, clinicians and experts who shared data as they tried to better understand the swine flu in order to "prevent overwhelming mortality and severe disease," Shindo said.

by Staff Writers
Washington (AFP) Oct 16, 2009
US health officials warned Friday that deliveries of swine flu vaccine may be delayed as influenza deaths climbed above epidemic levels in most states, hitting children particularly hard.

Eleven more children were reported to have died of flu in a single week, with 10 of the pediatric deaths confirmed by laboratory tests as being from H1N1 flu, Anne Schuchat, a senior official at the Centers for Disease Control and Prevention (CDC), told reporters.

Since April, when the swine flu outbreak began in Mexico, 86 children in the United States have died of the new strain of H1N1, Schuchat said.

In the worst of the past three flu seasons in the United States, which usually run from August to March, 88 children died.

As of the middle of this week, 11.4 million doses of H1N1 vaccine were available and around eight million had been ordered by the states, where innoculation clinics got under way last week.

Long lines have been reported outside the clinics, as parents rushed to get their children -- one of the most at-risk groups -- innoculated against swine flu.

Since August 30, 43 pediatric deaths from influenza have been reported to the CDC, and laboratory tests have confirmed that 38 of those deaths were caused by the H1N1 virus, Schuchat said.

Half of the confirmed pediatric H1N1 deaths since the end of August were in children aged 12 to 17, and only slightly fewer -- 16 -- in five- to 11-year-olds.

When H1N1 was first reported in Mexico, from where it spread rapidly to the United States, many of the pediatric deaths were in very young children and infants.

Schuchat warned that deaths of older children from swine flu were likely to increase as the autumn influenza season progresses.

Overall, deaths in the United States from flu have leapt above the "epidemic threshold," and widespread disease from influenza has been reported in 41 of the 50 states. The remainder of the states are seeing higher-than-average rates of illness, Schuchat said.

"It's unprecedented for this time of year to have the whole country seeing such high levels of activity," Schuchat said.

Most of the flu in the United States is H1N1 influenza.

But as deaths rose and flu spread, H1N1 vaccine manufacturers have warned of slow-downs in production.

"It doesn't look like we're going to be able to make the estimates we had projected by the end of this month," Schuchat said, scaling back earlier projections of 40 million doses of vaccine by the end of October to 28-30 million.

One reason for the production log-jam was the barrage of tests, including tests for strength and purity, which the vaccine is subjected to.

"We are not cutting any corners in the safety of the production of this vaccine or the testing and oversight of the vaccine," said Schuchat.

New York health care workers on Thursday took legal action to try to halt the massive swine flu vaccination program being rolled out across the United States, claiming the vaccines have not been properly tested and are not safe.

The state of New York requires that doctors, nurses and other medical professionals who have contact with patients must be vaccinated against H1N1 flu, but for most people getting vaccinated against swine flu is voluntary.

The CDC expects to roll out at least 800 million doses of swine flu vaccine, with "the possibility of producing more as needed," Llelwyn Grant, a spokesman for the federal health agency, said.

At least 4,735 people have died from swine flu infections since April, according to the World Health Organization.

Most deaths occurred in the Americas region, where 3,406 fatalities have been reported.

US drug safety watchdog warns of bogus swine flu meds
The US Food and Drug Administration (FDA) on Friday warned consumers to avoid buying medicines online to treat swine flu, saying one such product contained nothing more than talc and over-the-counter fever-reducer.

The FDA raised the warning after some of its investigators purchased and analyzed products represented online as Tamiflu (oseltamivir), one of the anti-viral medicines that has been shown to be effective against A(H1N1) flu.

"One of the orders, which arrived in an unmarked envelope with a postmark from India, consisted of unlabeled, white tablets taped between two pieces of paper," the food and drug safety watchdog said.

"The tablets were found to contain talc and acetaminophen (paracetamol), but none of the active ingredient oseltamivir," it said.

In buying several of the products, the FDA investigators were not asked to produce a doctor's prescription.

The two antiviral drugs approved by the FDA for treatment and prophylaxis of the 2009 A(H1N1) influenza virus, Tamiflu and Relenza, require prescriptions.

"Medicines purchased from websites operating outside the law put consumers at increased risk due to a higher potential that the products will be counterfeit, impure, contaminated or have too little or too much of the active ingredient," FDA Commissioner Margaret Hamburg said.

Patients who buy prescription drugs from websites run an "increased risk of suffering life-threatening adverse events, such as side effects from inappropriately using prescription medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs," the FDA said.

Bogus drugs are more common in times of a public health emergency, such as an influenza outbreak, when unlicensed manufacturers take advantage of high demand for medications and try to turn a quick profit, the FDA warned.

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Swine flu less deadly than seasonal flu, official says
Stockholm (AFP) Oct 14, 2009
Swine flu is killing fewer people than seasonal flu but is causing greater alarm due to its impact on children and higher healthcare costs, according to a top disease surveillance expert. Denis Coulombier, who heads the European Centre for Disease Prevention and Control's preparedness and response unit, warned that a second wave of swine flu infections could be expected within weeks. In ... read more

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