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Showing posts with label blog. Show all posts

Thursday, September 24, 2009

Pvt hospitals still not ready for Swine flu

More than a week after Delhi Government's second deadline expired on September 15, private hospitals are yet to open doors to influenza A H1N1 patients.

Delhi reported 2,079 cases - 80 new cases - and 9 deaths till Wednesday evening. While most of the hospitals claimed to be ready and waiting for the state health department's approval, State Health Minister Kiran Walia said they were not.

"Our experts are going on a round of private hospitals virtually every day, and there are minor things that are hampering the approval process like system of ventilation," said Walia. "These hospitals aren't used to the concept of isolation and mostly work in a centralised system.

We may delay it by a few days but absolute compliance is a must. We can't cut corners and risk lives of people," she said.

"Our set-up is ready and we have conveyed this to the health department. Now, we are waiting for their inspection," said B.K. Rao, chairman of Sir Ganga Ram Hospital.

"Our infrastructure is in place, but we are awaiting formal approval from the government," said the Moolchand Medcity spokesperson. Similar reactions were given by Indraprastha Apollo Hospital, which said the hospital was waiting for the second inspection before starting the facility for swine flu patients.

On August 12, Principal Secretary (health) J.P. Singh issued a circular directing "all 200-bed non-government medical institutions/hospitals to set up a 10-bed isolation treatment facility with 15 days". The direction was issued under section 2 of the Epidemic Disease Act, 1897, which empowers the state government to take special measures and prescribe regulations in case of a dangerous epidemic disease.

"The step was taken as a precautionary measure in case the disease takes epidemic shape," said Singh. The hospitals had asked for more time and the state government extended the deadline by 15 days.

But none of the wards were functional

Tuesday, May 26, 2009

Flu scare reveals strapped local health agencies

The swine flu outbreak fell short of a full-blown international crisis, but revealed the precarious state of local health departments, the community bulwarks against disease and health emergencies in the United States.

A sustained, widespread pandemic would overwhelm many departments that are struggling with cutbacks as well as increased demand from people who have lost jobs and medical insurance.

Stung by the lean economy, 13 states and U.S. territories had smaller health budgets in 2008 than in 2007, and eight more made midyear cuts, according to a survey by an advocacy group, the Association of State and Territorial Health Officials. With local budgets also in trouble, many health officials fear a serious outbreak.

"We would be in a lot of trouble," said Alameda County's director of public health, Anthony Iton in Oakland. "We weren't tested to push the system to see how it responds when you have to make hard decisions. I worry about that because the resources have been cut."

A review by the U.S. Health and Human Services Department in January noted great strides in preparedness but said many shortfalls remain. They include the ability to maintain public health functions such as food safety and daily needs during a pandemic, and the capacity to meet surges in health care demand and to strategically close schools.

State capabilities vary. But some local departments, strapped by layoffs and working overtime on swine flu, say they could not maintain the pace in a major outbreak. An Associated Press review found troubling signs:

_Twenty-nine public health workers in Sacramento County, Calif., learned just before being called to work on swine flu that they probably will lose their jobs this summer. Senior nurse Carol Tucker, contacting potential flu victims, thought about future epidemics.

"Who will be around to do these things?" she said.

_Nationwide, officials have reported more than more than 6,700 swine flu cases, and 12 deaths.

"We have good plans and we're exercising them," said Matthew A. Stefanak, health commissioner of Mahoning County, Ohio, whose work force dropped 20 percent in two years. "But for the nuts and bolts of an outbreak - contact investigations, probable cases of H1N1 flu - we don't have the manpower, the trained disease investigators the public health nurses who would do it. That's where we're weakest right now."

_Federal investment in local emergency planning since attacks of Sept. 11, 2001, has paid off in a smooth response to the limited swine flu outbreak. But the money has dwindled.

Last year at least 10,000 local and state health department jobs were lost to attrition and layoffs, including at laboratories that identify disease strains, according to surveys by the state and territorial group and the National Association of County and City Health Officials.

An annual flu-shot clinic no longer comes to town hall in Berlin Center, Ohio. "The real danger is how many just won't get shots," said Ivan Hoyle, 78.

Public health nurses such as Erica Horner won't deliver in-home newborn help in Mahoning County. With the program closed, Horner's duties will change.

_People calling for routine immunizations now reach a recording saying the Worcester, Mass., clinic is closed. With just two of its six public health nurses surviving layoffs, the city is re-evaluating its responsibilities and says it can meet emergencies by working with the University of Massachusetts and local hospitals.

Ann Cappabianca, one of the remaining nurses, scrambles to track communicable disease and tuberculosis cases. "We just can't get it all done. You try to focus on the most important thing at the moment," she said.

Worst is having to make cuts without "enough ability to assess the needs of my community," said Bob England, the health director of Arizona's sprawling Maricopa County, which closed its family planning clinic.

Public health departments will get some help from this year's stimulus spending of $1 billion for prevention and wellness efforts.

But it will take years to bring local health agencies to the point where they can fight a sustained, widespread pandemic, said Richard Hamburg, a lobbyist at the nonprofit Trust for America's Health, an advocacy group supported by private and government grants.

A report from the group in December found emergency planning gaps in areas such as rapid disease detection, food safety and "surge capacity" to quickly scale up equipment, staff and supplies to meet a major outbreak.

Dan Sosin, head of emergency response at the Centers for Disease Control and Preparedness, praised the federal swine flu response, but acknowledged that public health officials face "capacity issues in terms of ongoing resources and funding."

"We could spend more money," he said. "We could use more than we have."

The CDC's acting director, Richard Besser, told Congress last month the government is concerned about states being too short-staffed to conduct required emergency exercises.

The main fund for local health emergency planning after the Sept. 11 attacks, the federal Public Health Emergency Preparedness program, has dropped nearly one-third since a 2006 peak of almost $1 billion, according to CDC figures. The money had included a special three-year congressional allocation for pandemic flu preparation that ran out last year.

President Barack Obama now is asking Congress for $1.5 billion to fight swine flu.

A second fund to help local agencies plan for public health emergencies, the Hospital Preparedness Program, has fallen nearly a quarter from $457 million in the 2006 budget year.

Decreases in the Public Health Emergency Preparedness program were most significant in Iowa, Mississippi, Colorado, Missouri, Michigan, Ohio, Pennsylvania and Louisiana. After a pair of killer hurricanes hit Louisiana in 2005, Washington sent nearly $15 million in 2006 health emergency help. This year, it's down to $9.8 million.

Louisiana's dollars from the hospital program slid from $7.1 million in 2006 to $5.2 million this year.

Even New York City, site of one of the Sept. 11 attacks, saw its Public Health Emergency Preparedness program funds fall to $20.6 million this year from $28.7 million during the 2006 budget year.

In Orange County, Fla., people were diverted from other duties for swine flu needs in a health department increasingly burdened with a range of demands as people lose jobs, said health director Kevin Sherin.

Sherin, president of the advocacy group American Association of Public Health Physicians, questioned longer-term capabilities for lab and field work in his state and elsewhere.

"In the event of a real emergency, these systems have capacity problems," he said.

Georges Benjamin, executive director of the American Public Health Association, a nonprofit lobbying group, said that after the federal emergency buildup, "We didn't complete the job and we didn't make the system sustainable. Our ability to manage more than one thing, or scale up fast is really worrisome."

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On the Net:

Association of State and Territorial Health Officials: http://www.astho.org/

Health and Human Services Department: http://www.hhs.gov/

National Association of County and City Health Officials: http://www.naccho.org/

Trust for America's Health: http://healthyamericans.org/

Centers for Disease Control and Preparedness: http://cdc.gov/

Public Health Preparedness Program: http://emergency.cdc.gov/cotper/cphp/

Hospital Preparedness Program: http://www.hhs.gov/aspr/opeo/hpp/

American Association of Public Health Physicians: http://www.aaphp.org/

American Public Health Association: http://www.apha.org/

Thursday, April 30, 2009

Three new swine flu cases in UK

THREE more victims of swine flu have been diagnosed in the UK — including a 12-year-old girl.
The English outbreaks were confirmed as it was revealed the killer bug had claimed its first death outside Mexico — a 23-month-old toddler in the United States.

The World Health Organisation warned the swine flu outbreak is moving closer to becoming a pandemic.

The 12-year-old is believed to have contracted the virus on a recent holiday to Mexico before returning to school at Paignton Community and Sports College in Devon this week.

Friends say she had been holidaying with her family on a farm in Mexico — where more than 150 people have died.

Charlotte Cleverdon, 11, a pupil at the school, said: "This afternoon at 1pm a teacher came in and told us what was happening and we were going home.

“Everyone started crying and holding their noses.”

The youngster was on the same flight as the Askhams, the Scottish couple who were the first UK victims to be diagnosed with swine flu
Lisa Walton, 36, who has two sons, Liam and Jack, at the school, said: “We just had no idea about what was happening here.

“The school had not told us about it, and my son said the pupils were told around 1pm today. Right now we just don’t know what to think. Obviously it’s a worry.”

The girl was one of three new confirmed cases announced by Gordon Brown at Prime Minister’s Question Time with the other two in Birmingham and London.

And new information providing advice about the swine flu outbreak will be up and running tomorrow, Health Secretary Alan Johnson said tonight.

Updating MPs on the “very fast moving situation” he said concerned members of the public will be able to call 0800 1513513 from tomorrow for recorded information about the virus

Paignton College — which has more than 1,900 pupils — is being closed until Monday, May 11, in a bid to minimise the spread of the infection.

Pupils were sent home with a letter from Principal Jane English which said: “A pupil in Year 7 has been confirmed as having swine flu.

“The pupil is at home and is recovering well.”

The Health Protection Agency in Devon identified that the girl had been in close contact with 50 fellow pupils and others, Health Secretary Alan Johnson said.

He added that Tamiflu anti-virals had now been given to 230 pupils — the whole of her school year — as a precautionary measure.

Liberal Democrat MP for Torbay Adrian Sanders said: "We need people to remain calm and listen to advice from the health authority."

The two other victims were said to be a 41-year-old woman, from Redditch, Worcs, and a 22-year-old man from north west London.

Another 76 patients were being tested around the UK, 20 of whom were in Wales.

A total of 32 possible cases were now under investigation in Scotland.

The PM also confirmed today that the NHS is trying to buy "millions" more face masks to protect nurses and doctors treating flu victims — 18 months after The Sun exposed sham promises to stockpile them.

The Government will also increase the number of doses of anti-virals from 35million to 50million.

And health bosses revealed today leaflets on swine flu will be sent out to every UK household.

The virus is now known to have spread to EIGHT countries.

The first victim of swine flu in the US was a 23-month-old Mexican boy who travelled to Texas from Mexico.

Authorities in Houston said the boy was first admitted to hospital in the border town of Brownsville.
He had flown to the US with his parents from Mexico City and was staying with relatives.

The toddler fell ill soon after arriving on April 4 developing a fever and flu like symptoms.

His condition deteriorated and on April 13 he was taken to hospital in Brownsville and later transferred to a Houston area hospital where he died on Monday.

Health chiefs said the boy had flown from Mexico City to Matamoros on a commercial flight.

In Geneva, WHO flu chief Dr Keiji Fukuda said there was no evidence the virus was slowing down – and becoming a pandemic

This could lead the agency to raise its pandemic alert to phase 5 – warning of widespread human-to-human transmission.

In Spain - where 10 people have been confirmed with swine flu - a first case was discovered of someone catching the disease WITHOUT travelling to Mexico.

UK people can contact Here

Experts fear a pandemic will see four in ten Brits go down with the bug.

But manufacturers of masks said Britain had NO CHANCE of getting enough — because other countries had snapped them up.

Britain's first contaminated victims were yesterday revealed to be honeymoon couple 27-year-old Iain and Dawn Askham, 24.

The Scot newlyweds fell ill days after returning to their home near Falkirk from Cancun a week ago.

Eight people who have been in contact with them have tested negative for the virus, Scotland Health Secretary Nicola Sturgeon said today.

Ms Sturgeon also told parliament she had spoken to Mr Askham on the telephone.

She said: “A short while ago, I spoke to Iain Askham and passed on very best wishes of this parliament and the whole country to both him and his wife Dawn.


“I am pleased to report that they are continuing to recover in hospital.”

The H1N1 virus has killed 159 out of 2,498 infected in Mexico but Britain claims to have enough anti-viral drugs to fight the virus.

The Government pledged four years ago to stockpile disposable masks for NHS staff in any pandemic. But 18 months ago we revealed a chronic shortage.

Makers Moldex-Metric said: “It smacks of incompetence.”

Tour firms axed flights to Mexico as the Foreign Office warned against trips.

The US has confirmed 68 cases, Canada 13 and New Zealand 14.

This morning Germany confirmed three cases with others ill in Austria and Israel.

Egypt has even ordered the culling of ALL pigs in the Arab country as a precaution against swine flu, the country’s health minister said today.

A pandemic could see 25million here catch it in months.

Professor Neil Ferguson, of London’s Imperial College, said: “We might expect up to 40 per cent of the population to become ill.”

The World Health Organisation is holding a “scientific review" of the outbreak to collect what is known about how the disease spreads, how it affects human health and how it can be treated.

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Prevention of transmission to humans

Prevention of spread in humans

Influenza spreads between humans through coughing or sneezing and people touching something with the virus on it and then touching their own nose or mouth.Swine flu cannot be spread by pork products, since the virus is not transmitted through food.The swine flu in humans is most contagious during the first five days of the illness although some people, most commonly children, can remain contagious for up to ten days. Diagnosis can be made by sending a specimen, collected during the first five days, to the CDC for analysis.

Recommendations to prevent spread of the virus among humans include using standard infection control against influenza. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public.Although the current trivalent influenza vaccine is unlikely to provide protection against the new 2009 H1N1 strain,vaccines against the new strain are being developed and could be ready as early as June 2009.

Experts agree that hand-washing can help prevent viral infections, including ordinary influenza and the new swine flu virus. Influenza can spread in coughs or sneezes, but an increasing body of evidence shows little particles of virus can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes. Alcohol-based gel or foam hand sanitizers work well to destroy viruses and bacteria. Anyone with flu-like symptoms such as a sudden fever, cough or muscle aches should stay away from work or public transportation and should see a doctor to be tested.

Social distancing is another tactic. It means staying away from other people who might be infected and can include avoiding large gatherings, spreading out a little at work, or perhaps staying home and lying low if an infection is spreading in a community.