H1N1 vaccine data shows no side effects

Early data on the H1N1 vaccines show the vaccines to be highly effective with no adverse effects. Two peer-reviewed articles now published in the online first addition of new England Journal of medicine, which has the preliminary data of the monovalent H1N1 vaccine, have shown that the vaccines are working in a large number of healthy adults.

The two rivals, Greenberg et al and Clark et al, describe preliminary data on the immunogenicity of the influenza A (H1N1) 2009 monovalent vaccine. This data has been awaited, as governments, public health officials, and other stakeholders respond to the first influenza pandemic in over 40 years.

The study by Greenberg et al. shows that a single dose of nonadjuvanted vaccine containing the usual 15 �g of hemagglutinin (HA) antigen is immunogenic, or creates immunity, in a high proportion of healthy young and middle-aged adults. The study was conducted in Australia during a time when the virus was circulating, and one participant had laboratory-confirmed infection with the 2009 H1N1 virus.

The report evaluates immunogenicity and safety of the vaccine 21 days after the first of two scheduled doses is given. A total of 240 subjects, equally divided into two age groups, less than and over 50 years of age, underwent randomisation to receive either 15 �g or 30 �g of hemagglutinin antigen by intramuscular injection. No deaths or serious adverse events were reported, but mild discomfort like headaches were reported in a few cases.

The study by Clark et al, involving 175 adults between 18 to 50 years of age, to test the monovalent influenza A/California/2009 (H1N1) surface-antigen vaccine, concluded that the vaccine generates antibody responses within 14 days after a single dose is administered. The antibody tier protection was higher in those who had received two doses of the same vaccine.

What scientists know about swine flu

Preliminary analysis of the swine flu virus suggests it is a fairly mild strain, scientists say.

It is believed that a further mutation would be needed in order for the H1N1 virus to cause the mass deaths that have been estimated by some.

But at this point, it is impossible to predict with any accuracy how the virus will continue to evolve.

UK experts at the National Institute for Medical Research outlined on Friday the work they are due to start on samples of the virus sent from the US.

The research, being done at the World Influenza Centre in Mill Hill, will be vital for working out the structure of the virus, where it came from, how quickly it is capable of spreading and its potential to cause illness.

Structure

Analysis done so far suggests what they are dealing with is a mild virus and nowhere near as dangerous as the H5N1 avian flu strain that has caused scientists so much concern over the past decade.

Influenza A viruses are classified according to two proteins on the outer surface of the virus - hemagglutinin (H) and neuraminidase (N).


The swine flu strain is a H1N1 virus, the same type as seasonal flu which circulates throughout the world every year, and kills roughly 0.1% of those infected or higher in an epidemic year.

Professor Wendy Barclay, chair in influenza virology at Imperial College London says initial indications suggest there is nothing about the genetic make-up of the new virus which is a cause for particular concern.

The key to its potential lies largely in the H1 protein.

"There are two aspects - one is which receptors the virus tends to bind to and what we see is that it is binding to the upper respiratory tract rather than deep in the lungs."

When a flu virus binds to the upper respiratory tract, it tends to cause mild illness but can be easily spread as people cough and sneeze, Professor Barclay explains.

If a virus binds further down in the lungs, it tends to cause much more severe illness, as in the case of the H5N1 avian flu virus which has caused concern in recent years.

"With the H1 gene we also look at the cleavage site," she adds.

"The virus has to be cut into two pieces to be active and it uses an enzyme in the host to do that.

"Most influenza viruses are restricted to the respiratory tract because they use enzymes in the lungs.

"But some, like H5 viruses can evolve to cut into two pieces outside the lungs, so they can replicate outside the respiratory tract."


Analysis

These initial indications are largely guesswork from looking at the genetic sequence of the virus and comparing that to what is known from work on other influenza viruses.

It will take weeks and months of biological analysis to properly get a handle on the potential of the H1N1 virus.

The team at Mill Hill, one of four World Health Organisation's centres for influenza research will be working in close collaboration with the Health Protection Agency who are carrying out testing in the UK, and their findings will also feed into the development of a potential vaccine.


Soon, the Wellcome Trust Sanger Institute in Cambridge will begin the genetic sequencing of the virus and will also be monitoring any mutations or changes in how virulent it is.

However, there is one other reassuring aspect about what is known so far.

That is there seems to be nothing unusual as yet in another protein in the centre of the virus, called NS1, which is linked to the strength of the immune response the virus produces.

In some more pathogenic viruses, it is this NS1 protein which initiates a "cytokine storm", a particularly severe immune reaction that can be fatal in even healthy young people.

Predictions

Scientists have also played down concerns that the milder H1N1 virus, could combine with the more dangerous H5N1 avian flu virus, causing a super virus that has the ability to both spread easily between humans and cause severe illness.

This is unlikely - or at least just as unlikely as it ever was and the H5N1 virus has been around for a decade without combining with normal seasonal flu.

Professor Jonathan Ball, an expert in molecular virology at the University of Nottingham said: "The chance of swine H1N1 combining with H5N1 is as likely as any other strain recombining.

"What this outbreak does highlight is how difficult it is to predict new pandemic strains.

"Many people suspected that H5N1 was the most likely candidate for the next pandemic strain, but now it appears that this was a mistake - but that's not to say H5N1 or another reassortment containing parts of H5N1 may not happen in the future.

"That's the trouble - you can't predict."

Q&A: Swine flu vaccination

The government has unveiled its vaccination programme.

A number of priority groups have been identified and the process should start in October.

What is the current status of the vaccine?



Doses of the vaccine have already been produced. A total of 300,000 doses from the two firms the UK has contracts with are due to be delivered this month.

Human trials are now getting under way and if they go well regulators could approve the jabs by the end of September.

Like seasonal flu vaccines, the jabs can be licensed under a fast-track procedure.

The vaccines have already been tested with a different strain of flu and proven to be safe.

So they just need limited testing with the correct strain to get the green light.

This means the process can take just a month or so, unlike new drugs which can take years to get approval.

How have the priority groups been identified?

The government's official vaccination experts have been studying at the evidence about swine flu for the past few months.

The health service just does not have enough capacity to administer the two shots of the swine flu vaccine needed to give protection to everyone in time for the winter.

So, instead, the government has announced a list of priority groups.

These are mainly people who are most at risk of complications or, in the case of health and social care workers, the people who are most likely to come into contact with the virus.

Many had thought all children would be immunised as they have been getting the infection in the highest numbers.

But the experts decided against such a mass programme as the overwhelming majority of those developing complications were the children with serious health problems.

How does this compare to the seasonal flu programme?
The initial first wave of the vaccination programme is not that different from the average seasonal flu vaccination group.

Only pregnant women and those living with people with immune system problems, such as people with HIV or those receiving chemotherapy treatment, will be getting the swine flu jab without also receiving the seasonal flu one.

The government hopes to be able to combine vaccinations for people who need both.

How will the swine flu vaccine be administered?

The government is still in negotiation with GPs about how the programme will be delivered.

But the vaccine requires people to be given two doses, three weeks apart.

That would mean the first phase of the programme will take until at least early December to complete.

Will everyone be vaccinated?

It is not clear. The government said it will make a decision on this during the winter.

It will eventually have enough vaccine for the whole population, but in most cases it has remained a relatively mild infection.

However, Chief Medical Officer Sir Liam Donaldson has warned that it could still become more deadly and while the death toll remains low, a fifth of cases have involved previously healthy people

Swine flu deaths mount to six India

The number of people to die of swine flu in India has risen to six with the death of a number of patients over the weekend, health officials say.

Six patients are reported to be in a serious condition in the western city of Pune, which has recorded more cases than anywhere else in India.

A number of schools in the country have been shut temporarily over fears of children contracting the disease.

Officials say there are more than 800 cases of the H1N1 flu strain in India.

The virus is thought to have killed almost 800 people around the world.

A 53-year-old doctor of indigenous medicine and a four-year-old boy died in hospitals in western Pune and southern Chennai cities early on Monday, taking the number of deaths caused by swine flu to six.

Over the weekend, three people died of the flu in western India - a 43-year-old businessman who was visiting Ahmedabad city in Gujarat state; a 42-year-old teacher in Pune city; and a 53-year-old woman in Mumbai city.

Last Monday, a 14-year-old girl became the first person in the country to die of swine flu.

Rising concerns

Health officials say that the country had enough stocks of the anti-flu drug Tamiflu.

However, panic is growing among the people with swine flu deaths making it to the front pages of newspapers and main TV news.

Several schools in western Indian and the capital, Delhi, have closed temporarily as fears grow about children contracting the flu.

In Delhi, where some 228 cases have been confirmed, health officials say that the people are panicking "because the symptoms of swine flu and common influenza are similar".

As the number of flu deaths rise in the country, health officials have asked people not to panic.

Indian PM Manmohan Singh has asked the health ministry to step up preparedness against the disease and coordinate with state governments to spread the disease.

"All state governments have been asked to set up their own swine flu helplines, create more quarantine wards not only in their hospitals but also in the big private hospitals," federal Health Minister Ghulam Nabi Azad said.

The BBC's Soutik Biswas in Delhi says though the number of swine flu deaths in India was still low, there are concerns over the ability of the badly-run and under equipped government hospitals to handle the rising tide of patients.

Also, the 12 swine flu testing centres in India will not be sufficient if the number of cases rise sharply, our correspondent says.

"We need to work out a public-private partnership between the hospitals to tackle the flu. We need to take the people, doctors and media into confidence so panic does not spread," federal Junior Health Minister Dinesh Trivedi told the BBC.

Last week, the World Health Organization announced that the first swine flu vaccines are likely to be licensed for use in the general population in September.

The swine flu (H1N1) virus first emerged in Mexico in April and has since spread to 74 countries.

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Pune/Chennai, Aug 10 (PTI) A 35-year-old ayurvedic doctor and a four-year-old boy died of swine flu in Pune and Chennai today, taking the toll due to the dreaded viral infection in the country to six. The medic, Babasahib Mane, died in the Sassoon Hospital in Pune this morning, becoming the third person in the worst-hit Maharashtra city to succumb to swine flu, a senior health official said.

Mane was ailing for sometime and blood had been found in his sputum in the last couple of days, he said. In Chennai, a four-year-old boy, who was admitted to a private hospital with kidney and liver-related complications and had tested positive for swine flu, died this morning, health officials said.

The boy had also been suffering from asthma. This is the first case of flu death in the city.

"The boy was in a very critical condition. He had been suffering from asthma and he had been taken from one hospital to another for various complications.

Ultimately he landed up in this hospital for a kidney-related problem.

and they found the boy testing positive (for swine flu)," Tamil Nadu Health Secretary V K Subburaj said.

The boy, who was on a ventilator, died following "multi- organ failure," S Ilango, Director of Public Health, said. With the two deaths today, the swine flu toll in the country has climbed to six.

First Swine Flu death in India

Swin flu pandemic song
Uploaded by gloubi77. - News videos from around the world.

Pune, August 03 2009: India recorded its first Swine flu death today in Pune.

A young girl named Riya Shiekh died at a private hospital in Pune on Monday, 3rd August.

She was on a ventilator in an ICU for a number of days, reports swin-flu.india.org.

Pune has recorded the most number of cases of Swine flu in India.

India now has over 551 confirmed cases flu out of which 422 have been cured and discharged.

However there have been a number of cases where the virus has reappeared in patients.

Statistics have revealed that children below the age of 15 are more susceptible to the virus.

UK moves from swine flu 'containment' to 'treatment'

The UK has moved from the 'containment' to the 'treatment' phase of swine flu as the number of people catching swine flu continues to rise.

'Containment' to 'treatment'
As Swine Flu spreads and more people start to catch it in their communities, the government has moved from efforts to contain the virus to treating the increasing number of people who have the disease.

The move from containment to treatment will apply in all four nations of the UK- England, Scotland, Wales and Northern Ireland.

This means that:

GPs will be able to diagnose swine flu on the basis of symptoms rather than waiting for laboratory testing

all tracing of people who have been in contact with a sufferer will stop

people who may have been exposed to the virus will not be given anti-viral drugs

anyone who is diagnosed with swine flu will continue to be offered anti-virals until further notice
Local primary care trusts will also begin to establish anti-viral collection points in their local communities. These could be at a designated pharmacy or a community centre, depending on local need.

Health Secretary Andy Burnham said:"Most cases of swine flu have not been severe and we are in a strong position to deal with this pandemic.

"But we must not become complacent and, while doubt remains about the way the virus attacks different groups, today's decision on the move to the treatment phase reflects our caution."

Synthetic flu vaccine option?

A company claims it has created a synthetic version of the swine flu vaccine. CNN's Dr. Sanjay Gupta reports.
Watch the Videos now .

China quarantines U.S. school group over flu concerns

A group of students and teachers from a Maryland private school have been quarantined in China because of swine flu concerns, a school spokeswoman said Thursday.

The Chinese government has confined 21 students and three teachers to their hotel rooms in Kaili, China, because a passenger on their plane to China was suspected of having swine flu, or H1N1, said Vicky Temple, director of communications for the Barrie School in Silver Spring, Maryland.

Temple said the students and teachers are occupying two floors of a four-star hotel in the Guizhou province city in southern China.

The quarantine will end Friday, and the students are scheduled to return to the United States on Sunday, Temple said.

Mike Kennedy, the head of Barrie School, said U.S. consular officials have since told the school that the plane passenger does not have swine flu, or H1N1.

"So now our question has been for the last 24 hours, can this quarantine be lifted even sooner than sometime on Friday so these kids can get out and enjoy a little bit of China," he said.

"Since about noon on Monday, they have been in their hotel rooms," he said. "They've missed the lion's share of the itinerary."

China's state-run Xinhua news agency reported that the Guizhou province's health bureau announced this week that it had discovered two dozen Americans who had been within four rows of the suspected swine flu case on the plane.

The plane had departed Friday from San Francisco, California.

Kennedy said the students and teachers are permitted to speak to one another through the open doors of their hotel rooms, but are not allowed to leave. "They're being well taken care of, but they are in their hotel rooms," he said.

"It's very frustrating," he said, but added, "I understand and I'd like to say that the Chinese officials have been as kind and friendly to our kids and chaperones as they can be."

State Department spokesman Ian Kelly said in a Thursday afternoon briefing that he was aware of the report but said he didn't have any details on the circumstances or what the U.S. officials might be doing about it.

Home Remedies to Avoid Swine Flu

Always cover your mouth and nose when coughing or sneezing; ideally use something disposable like a tissue. Avoid touching your face, nose or mouth too frequently with your hands since swine flu appears to be transmitted through respiratory droplets in the same fashion as the common cold.

Wash your hands frequently with soap and water since swine flu like other viruses can be contracted by touching objects contaminated by the virus. It's unsure how long the swine flu virus can survive on surrounding surfaces.

Though alcohol based hand sanitizers don't routinely kill viruses they probably do offer some limited protection in preventing swine flu infections.

If swine flu infections have been medically confirmed in your area consider avoiding large public gatherings. Individuals can be contagious with the swine flu virus for several day before demonstrating any signs or symptoms of infection. Be particularly careful about indoor gatherings where air circulates poorly.

If you're really paranoid and don't mind looking odd then consider wearing a respiratory mask.. This barrier method does offer some basic protection against infection though not all masks are created equally. Higher quality masks capable of filtering out some respiratory infections are more expensive.

If you start feeling ill with cold or flu-like symptoms do not go to work. Stay home and begin the usual home remedies for colds and flu. Contact your health care provider, local health department or hospital emergency room if your symptoms worsen or fail to improve for information about where to go to be screened for possible swine flu infection.



What is Swine Flu? its signs and symptoms
In this video, Dr. Joe Bresee with the CDC Influenza Division describes swine flu - its signs and symptoms, how it's transmitted, medicines to treat it, steps people can take to protect themselves from it, and what people should do if they become ill.

What is H1N1 (swine flu)?
H1N1 (referred to as “swine flu” early on) is a new influenza virus causing illness in people. This new virus was first detected in people in the United States in April 2009. Other countries, including Mexico and Canada, have reported people sick with this new virus. This virus is spreading from person-to-person, probably in much the same way that regular seasonal influenza viruses spread.

To be more specific, Swine flu is a respiratory disease, caused by influenza type A which infects pigs. There are of many types, and the infection are constantly changing. Until now it had not normally infected humans, but the latest form clearly does, and is spread from person to person - probably through coughing and sneezing.

The World Health Organization has confirmed that at least some of the human cases are a never-before- seen version of the H1N1 strain of influenza type A. H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis. But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

Pigs provide an excellent 'melting pot' for these viruses to mix and match with each other.

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu. These include fever, cough, sore throat, body aches, chills and fatigue. Most cases so far reported around the world appear to be mild, but in Mexico lives have been lost.

Why is this new H1N1 virus sometimes called “swine flu”?
This virus was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to influenza viruses that normally occur in pigs in North America. But further study has shown that this new virus is very different from what normally circulates in North American pigs. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia and avian genes and human genes. Scientists call this a “quadruple reassortant” virus.

Novel H1N1 Flu in Humans

Are there human infections with this H1N1 virus in the U.S.?
Yes. Cases of human infection with this H1N1 influenza virus were first confirmed in the U.S. in Southern California and near Guadalupe County, Texas. The outbreak intensified rapidly from that time and more and more states have been reporting cases of illness from this virus.

Is this new H1N1 virus contagious?
CDC has determined that this new H1N1 virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of this virus in people?
The symptoms of this new H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, like seasonal flu, severe illnesses and death has occurred as a result of illness associated with this virus.

How severe is illness associated with this new H1N1 virus?
It’s not known at this time how severe this virus will be in the general population. CDC is studying the medical histories of people who have been infected with this virus to determine whether some people may be at greater risk from infection, serious illness or hospitalization from the virus. In seasonal flu, there are certain people that are at higher risk of serious flu-related complications. This includes people 65 years and older, children younger than five years old, pregnant women, and people of any age with chronic medical conditions. It’s unknown at this time whether certain groups of people are at greater risk of serious flu-related complications from infection with this new virus. CDC also is conducting laboratory studies to see if certain people might have natural immunity to this virus, depending on their age.

How does this new H1N1 virus spread?
Spread of this H1N1 virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How long can an infected person spread this virus to others?
At the current time, CDC believes that this virus has the same properties in terms of spread as seasonal flu viruses. With seasonal flu, studies have shown that people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods. CDC is studying the virus and its capabilities to try to learn more and will provide more information as it becomes available.
Exposures Not Thought to Spread New H1N1 Flu

Can I get infected with this new H1N1 virus from eating or preparing pork?
No. H1N1 viruses are not spread by food. You cannot get this new HIN1 virus from eating pork or pork products. Eating properly handled and cooked pork products is safe.

Is there a risk from drinking water?
Tap water that has been treated by conventional disinfection processes does not likely pose a risk for transmission of influenza viruses. Current drinking water treatment regulations provide a high degree of protection from viruses. No research has been completed on the susceptibility of the novel H1N1 flu virus to conventional drinking water treatment processes. However, recent studies have demonstrated that free chlorine levels typically used in drinking water treatment are adequate to inactivate highly pathogenic H5N1 avian influenza. It is likely that other influenza viruses such as novel H1N1 would also be similarly inactivated by chlorination. To date, there have been no documented human cases of influenza caused by exposure to influenza-contaminated drinking water.

Can the new H1N1 flu virus be spread through water in swimming pools, spas, water parks, interactive fountains, and other treated recreational water venues?
Influenza viruses infect the human upper respiratory tract. There has never been a documented case of influenza virus infection associated with water exposure. Recreational water that has been treated at CDC recommended disinfectant levels does not likely pose a risk for transmission of influenza viruses. No research has been completed on the susceptibility of the H1N1 influenza virus to chlorine and other disinfectants used in swimming pools, spas, water parks, interactive fountains, and other treated recreational venues. However, recent studies have demonstrated that free chlorine levels recommended by CDC (1–3 parts per million [ppm or mg/L] for pools and 2–5 ppm for spas) are adequate to disinfect avian influenza A (H5N1) virus. It is likely that other influenza viruses such as novel H1N1 virus would also be similarly disinfected by chlorine.

Can H1N1 influenza virus be spread at recreational water venues outside of the water?
Yes, recreational water venues are no different than any other group setting. The spread of this novel H1N1 flu is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

Prevention & Treatment

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against this new H1N1 virus. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza.

Take these everyday steps to protect your health:

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.

* Avoid touching your eyes, nose or mouth. Germs spread this way.
* Try to avoid close contact with sick people.
* Stay home if you are sick for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. This is to keep from infecting others and spreading the virus further.

Other important actions that you can take are:

* Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
* Be prepared in case you get sick and need to stay home for a week or so; a supply of over-the-counter medicines, alcohol-based hand rubs, tissues and other related items might could be useful and help avoid the need to make trips out in public while you are sick and contagious.

What is the best way to keep from spreading the virus through coughing or sneezing?
If you are sick, limit your contact with other people as much as possible. If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Cover your mouth and nose with a tissue when coughing or sneezing. Put your used tissue in the waste basket. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner. CDC recommends that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where people have been identified with new H1N1 flu and become ill with influenza-like symptoms, including fever, body aches, runny or stuffy nose, sore throat, nausea, or vomiting or diarrhea, you should stay home and avoid contact with other people, except to seek medical care.

If you have severe illness or you are at high risk for flu complications, contact your health care provider or seek medical care. Your health care provider will determine whether flu testing or treatment is needed

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children, emergency warning signs that need urgent medical attention include:

* Fast breathing or trouble breathing
* Bluish or gray skin color
* Not drinking enough fluids
* Severe or persistent vomiting
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough

In adults, emergency warning signs that need urgent medical attention include:

* Difficulty breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting
* Flu-like symptoms improve but then return with fever and worse cough

Are there medicines to treat infection with this new virus?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with the new H1N1 flu virus. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. During the current outbreak, the priority use for influenza antiviral drugs during is to treat severe influenza illness.

The US authorities say that two drugs commonly used to treat flu, Tamiflu and Relenza, seem to be effective at treating cases that have occurred there so far. However, the drugs must be administered at an early stage to be effective. Use of these drugs may also make it less likely that infected people will pass the virus on to others


What is CDC’s recommendation regarding "swine flu parties"?
"Swine flu parties" are gatherings during which people have close contact with a person who has novel H1N1 flu in order to become infected with the virus. The intent of these parties is to become infected with what for many people has been a mild disease, in the hope of having natural immunity to the novel H1N1 flu virus that might circulate later and cause more severe disease.

CDC does not recommend "swine flu parties" as a way to protect against novel H1N1 flu in the future. While the disease seen in the current novel H1N1 flu outbreak has been mild for many people, it has been severe and even fatal for others. There is no way to predict with certainty what the outcome will be for an individual or, equally important, for others to whom the intentionally infected person may spread the virus.

CDC recommends that people with novel H1N1 flu avoid contact with others as much as possible. They should stay home from work or school for 7 days after the onset of illness or until at least 24 hours after symptoms have resolved, whichever is longer.

Contamination & Cleaning

How long can influenza virus remain viable on objects (such as books and doorknobs)?
Studies have shown that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface.

What kills influenza virus?
Influenza virus is destroyed by heat (167-212°F [75-100°C]). In addition, several chemical germicides, including chlorine, hydrogen peroxide, detergents (soap), iodophors (iodine-based antiseptics), and alcohols are effective against human influenza viruses if used in proper concentration for a sufficient length of time. For example, wipes or gels with alcohol in them can be used to clean hands. The gels should be rubbed into hands until they are dry.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk, for example, and then touches their own eyes, mouth or nose before washing their hands.

How should waste disposal be handled to prevent the spread of influenza virus?
To prevent the spread of influenza virus, it is recommended that tissues and other disposable items used by an infected person be thrown in the trash. Additionally, persons should wash their hands with soap and water after touching used tissues and similar waste.

What household cleaning should be done to prevent the spread of influenza virus?
To prevent the spread of influenza virus it is important to keep surfaces (especially bedside tables, surfaces in the bathroom, kitchen counters and toys for children) clean by wiping them down with a household disinfectant according to directions on the product label.

How should linens, eating utensils and dishes of persons infected with influenza virus be handled?
Linens, eating utensils, and dishes belonging to those who are sick do not need to be cleaned separately, but importantly these items should not be shared without washing thoroughly first.
Linens (such as bed sheets and towels) should be washed by using household laundry soap and tumbled dry on a hot setting. Individuals should avoid “hugging” laundry prior to washing it to prevent contaminating themselves. Individuals should wash their hands with soap and water or alcohol-based hand rub immediately after handling dirty laundry.

Eating utensils should be washed either in a dishwasher or by hand with water and soap.

The first case has already been reported from India from neighboring state of Andhra Pradesh.

What about bird flu?
The strain of bird flu which has caused scores of human deaths in South East Asia in recent years is a different strain to that responsible for the current outbreak of swine flu.

The latest form of swine flu is a new type of the H1N1 strain, while bird, or avian flu, is H5N1.

Experts fear H5N1 hold the potential to trigger a pandemic because of its ability to mutate rapidly.

However, up until now it has remained very much a disease of birds.

Those humans who have been infected have, without exception, worked closely with birds, and cases of human-to-human transmission are extremely rare - there is no suggestion that H5N1 has gained the ability to pass easily from person to person.

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/

Dr. Joe Bresee with the CDC Influenza Division describes swine flu

If you are eager to know about swin Flu the Listen this Video where the details describes about Signs & Symptoms

UK had again hit Swin Flu more cases observed

14 further patients under investigation in England have today (Sunday) been confirmed with swine flu bringing the current total number of confirmed UK cases to 101.

There are six adults and eight children among the new confirmed cases in the East of England, London and the South East regions – 11 contacts of previously confirmed cases, 2 returning travellers and one whose source of infection remains under investigation.

155 cases are currently under laboratory investigation in the UK. These cases change on a daily basis. Because of the time-lag between the reporting of symptoms, the testing and the results, the new cases reported daily may have recovered and may now be symptom-free.

Public gatherings
There are no restrictions on public gatherings like music festivals. The Department of Health is advising people to carry on with their daily lives as normal.

For Immediate Help

Agreements have been signed between the UK Government and vaccine manufacturers to secure Swin Flu

Agreements have been signed between the UK Government and vaccine manufacturers to secure supplies of up to 90 million doses of pre-pandemic H1N1 (swine flu) vaccine before a pandemic begins, the Department of Health has announced.

The deals signed between Secretary of State for Health, Alan Johnson, GlaxoSmithKline, and Baxter, will enable production of pre-pandemic vaccine to begin as soon as possible.

The agreements could provide enough vaccine to protect the most vulnerable in our population before a pandemic is likely to arrive, without affecting our supply of seasonal flu vaccine.

There are over 101 confirmed cases of swine flu in the UK. Most cases are linked to either previously confirmed cases or are returning travellers.

The pandemic flu alert level from the World Health Organization (WHO) remains at Phase Five. Other recent developments include: