Swine flu spreading fast Czech Republic 2011

Doctors report a heightened incidence of swine flu across the country with some regions having crossed the threshold of an epidemic. South Moravia reports a 17 percent increase in flu cases in the past week alone and five schools in the region have closed due to illness. The country’s chief hygiene officer has advised all Czech hospitals to close their doors to visitors. A dozen swine flu patients are reported to be on support ventilation in serious condition.

Slovakia reports its first swine flu death of season

Slovakian health officials Friday confirmed the country's first death due to swine flu this winter, dpa reported.

The victim was a 40-year-old man from the eastern city of Humenne. He died December 22.

Gabriel Simko, the acting director of the Slovakian Hygeine Authority, confirmed the death to the TASR news agency. Officials have reported seven infections due to the H1N1 virus this season, Simko said.

Swine flu - prevention, treatment and vaccine

If you think you have developed flu-like symptoms, you should stay at home and avoid contact with other people. (Contact NHS Direct on 0845 4647 who will use a checklist to diagnose if you have swine flu. If diagnosed, you will be given a voucher number for a ‘flu friend’ to get anti-viral drugs from a collection point).

Contact your GP for advice; most people with ‘flu need only rest in bed with plenty of fluids to drink and paracetamol for their temperature and aches and pains. However, vulnerable groups such as pregnant women, children under five, the over 65’s and those with a serious pre-existing condition such as heart disease, asthma, diabetes or immunosuppressive illnesses may need extra treatment such as anti-viral drugs.

These drugs, which include Tamiflu (Oseltamivir) or Relenza (Zanamivir), are available free of charge on the NHS. Novel H1N1 (swine flu) seems to respond to these medicines in the same way as seasonal flu. Pregnant women, people with health conditions and the under-ones will still all be referred to their GPs.

The treatments are not a cure but can reduce the risk of infection for those who have been exposed to the virus, reduce the ability of a person with the virus to pass it on, and shorten the course of the illness when someone has flu. Most importantly these drugs treatments reduce the risk of serious complications and death. For maximum effect, the drugs should be given as early as possible to someone who has the flu.

However, as with any medicines there may be side effects from anti-viral drugs. Many people with swine flu will only have mild symptoms and they may decide that a combination of rest and simple remedies for symptoms are all that they need.

Treat symptoms as they arise. Try to keep well hydrated with plenty of clear fluids. Take paracetamol or ibuprofen (children should not be given aspirin because of the risk of Reyes syndrome) for aches and pains, and use simple remedies such as cough syrups and vapour rubs. Try to rest as much as possible.

As with all infections, good hygiene is absolutely essential to reduce the risk of spread or contact with the virus:

* Wash your hands regularly
* Cover your mouth and nose when you cough or sneeze
* Use tissues and dispose of them carefully
* Clean hard surfaces regularly with a standard cleaning fluid
* Avoid close contact with people who have fever and a cough

The effectiveness of wearing a face mask in preventing transmission of the flu virus isn’t yet clear, although it may give some protection to those people such as health professionals who work closely with someone with symptoms of flu.

Don’t worry about eating pork products – there is no evidence that swine flu can be picked up that way. Even if virus is present in the meat, thorough cooking will destroy it.

Return of bird flu to South Korea sparks cull

South Korea has confirmed its first outbreak of avian flu since 2008 and is culling many thousands of birds.

The agricultural ministry confirmed that two farms in the centre and south-west of the country had been contaminated with the H5N1 virus.

So far, more than 100,000 chickens have been culled and more than 10,000 ducks.

South Korea was the second country in Asia to register bird flu, after Thailand, in 2003, suffering three major outbreaks until 2008.

Earlier this month, officials in Seoul confirmed that three cases of bird flu had been found in wild migratory birds that had arrived for winter.

The authorities have warned poultry farmers to take better precautions against wild birds infecting their flocks, including the erection of nets.

The latest outbreak was first detected on Wednesday when birds started dying.

One of the poultry farms affected is in the central city of Cheonan and the other is in the south-western city of Iksan, 90km (56 miles) and 230km (143 miles) south of Seoul, respectively.

Both are now under quarantine, meaning that the movements of people and vehicles are restricted.
Farming challenge

Exports of chicken, duck and related products will be affected.

"All the 10,700 ducks at the farm in Cheonan and 17,000 breeding chickens at the farm in Iksan have already been culled and buried, together with 92,000 chickens raised at nearby farms," the ministry said in a press statement.

South Korea has embarked on major culls before: more than eight million birds in 2008, 2.8m in the 2006-07 outbreak and 5.28m in 2003-2004.

South Korea has not registered any human fatalities from bird flu. Four people were infected in 2003.

Separately, South Korea recently confirmed an outbreak of 66 cases of foot and mouth disease, and has registered swine flu infections that have caused the death of one man.

More than half a million cattle, pigs and other cloven-hoofed animals have been culled in the past month, with vaccinations carried out on 313,000 animals.

A month-long quarantine effort has been struggling to keep pace with the contagious disease, since a confirmed infection on 29 November.

One of the farms affected, in Gyeonggi province just west of Seoul is the single largest producer of cattle in the country.

Agriculture ministry estimates suggest that losses from the foot-and-mouth outbreak could exceed $463m (£300m).

Swine flu death toll climbs to 66 in Madhya Pradesh

Bhopal, Sep 22 (PTI) With one more person succumbing to swine flu, the death toll due to the disease has risen to 66 in Madhya Pradesh, officials said today. Ramchandra (55) from Ratlam district succumbed to viral disease at the M Y Hospital in Indore on Monday, they said.

Bhopal has recorded 29 deaths since August while Indore (22), Jabalpur (10) Gwalior (3) and Harda (1) after the viral infection resurfaced in the state during monsoon. About 80 people are undergoing treatment for symptoms of HINI and the condition of 15 is stated to be critical.

Five more persons tested positive for the influenza virus yesterday. With this, the number of HINI cases in the state has gone up to 266 so far.

Swine flu cases increase with monsoon

Health Ministry officials are worried as the number of swine flu cases reported from various parts of the country are increasing with the monsoon. A total of 548 fresh cases were reported last week, the highest for the current year.

According to the health ministry, 38 people died of the virus between July 19 and 25.

While the four southern states and Maharashtra continued to be severely hit, West Bengal and Delhi also joined the list of flu cases. Maharashtra reported the highest number, with 230 cases this week, followed by Kerala with 108 cases. Karnataka reported 86 cases while Andhra Pradesh and Delhi reported 34 each, followed by West Bengal with 29 cases. Tamil Nadu reported 11 cases.

As many as 19 deaths were reported from Maharashtra, eight from Kerala, five from Andhra Pradesh, two in Delhi and one in West Bengal. A handful of cases have also been reported from Haryana, Gujarat, Uttar Pradesh and Jammu and Kashmir.

Meanwhile, the health ministry has recommended the use of swine flu vaccines to avoid the threat.

'The moisture due to monsoon is giving a good breeding ground to the virus, precautionary measures such as washing of hands, covering the nose and avoiding crowded places must be followed,' a health ministry official told IANS.

According to the health ministry, 1,692 deaths have been reported due to swine flu since its outbreak in May last year

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2009 H1N1 Flu: International Situation Update

This report provides an update to the international flu situation using data collected through March 28, 2010, and reported by the World Health Organization (WHO) on April 1. WHO continues to report laboratory-confirmed 2009 H1N1 flu cases and deathsExternal Web Site Icon on its Web page. These laboratory-confirmed cases represent a substantial underestimation of total cases in the world, as most countries focus surveillance and laboratory testing only on people with severe illness.

Currently, 2009 H1N1 influenza activity is highest in the tropical regions of Asia, the Americas and Africa. In the temperate areas of the Northern and Southern Hemisphere, 2009 H1N1 influenza virus continues to circulate at low levels. Although the 2009 H1N1 virus continues to be the predominant influenza virus circulating worldwide, influenza B viruses are predominant in most of East Asia and have been detected at low levels across Southeast and Western Asia, East Africa, and parts of Eastern and Northern Europe. Seasonal influenza A viruses are still being detected in parts of Asia and Australia.


Selected Highlights

* According to WHO, the majority of 2009 H1N1 virus isolates tested worldwide remain sensitive to oseltamivir, an antiviral medicine used to treat flu. Among 2009 H1N1 isolates tested worldwide, 268 have been found to be resistant to oseltamivir – 64 of these isolates were detected in the United States.
* Influenza B remains the predominant flu strain in East Asia, accounting for 66.7% of all influenza viruses reported in the Republic of Korea, 71.6% in the Russian Federation, 84.2% in China, and 100% in Mongolia and Iran. An increase in influenza B activity has also been reported in some European countries.
* Seasonal influenza A activity has been reported recently in some countries in recent weeks, including China, Ghana and Thailand.
* On February 18, 2010, WHO published recommendations for the following viruses to be used for influenza vaccines in the 2010-2011 influenza season of the Northern Hemisphere:

o an A/California/7/2009 (H1N1)-like virus;
o an A/Perth/16/2009 (H3N2)-like virus*;
o a B/Brisbane/60/2008-like virus.

* A/Wisconsin/15/2009 is an A/Perth/16/2009 (H3N2)-like virus and is a 2010 Southern Hemisphere vaccine virus.

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Swine Flu Cases Appear To Have Peaked

The Los Angeles Times:"The current wave of pandemic H1N1 appears to have peaked, with four weeks of declines in several key indicators, the Centers for Disease Control and Prevention said Monday. Despite the decrease, the outbreak is continuing to take a heavy toll of hospitalizations and deaths, especially among children. Widespread activity of H1N1, also called swine flu, was reported in 32 states ... in the week ending Nov. 21, down from 43 states the week before and 48 a month ago. Influenza-like illnesses accounted for 4.3% of all visits to doctors' offices during the week, down from nearly double that proportion in October. That is still well above the normal level, 2.3%, for this time of year, however" (Maugh, 12/1).

The Washington Post: "While officials warned that the number of people getting infected with the H1N1 virus remains high, and cases could surge again, the extended period of falling activity suggests that the intensity of the outbreak has reached a high. ... 'We're far from being out of the woods,' [Thomas Skinner, spokesman for the Centers for Disease Control and Prevention in Atlanta] said. 'There's still a lot of flu out there. And we wouldn't be surprised to see another uptick in activity as we approach the end of December and beginning of January, when kids come back from Christmas break.' But other experts said they thought the wave had peaked" (Stein, 12/1).

USA Today reports: "The steady decline in the USA and elsewhere prompted the World Health Organization to propose Friday that swine flu may have peaked in North America, the Caribbean and parts of Europe, though the 'winter influenza season continues to be intense.' U.S. officials challenged WHO's hopeful assessment, saying it is too soon to declare that swine flu is tapering off. ... As of Monday, 66 million doses of swine flu vaccine were available for states to order, and more were on the way, the CDC's Thomas Skinner says" (Sternberg, 11/30).

Meanwhile, The San Bernardino (Calif.) Sun reports that fewer blacks are receiving the vaccine: "San Bernardino County public health officials this week plan to make a special pitch to get more blacks to roll up their sleeves for the H1N1 vaccine. ... Alonzo Louis Plough, director of emergency preparedness and response at the Los Angeles County Department of Public Health, said last week that his agency had already made attempts at special outreach and participation in the H1N1 campaign, and participation is still lagging. ... Dr. Eric Frykman, health officer for Riverside County, said that he has asked clinic managers to informally start tracking participation by ethnic group" (Steinberg, 11/29).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at

Online Test Helps You Self-Diagnose H1N1 Flu

Feeling sick? Wondering if it's the H1N1 flu or just a regular old go-away-don't-come-near-me, flu?

Face it, your doctor may not be able to squeeze you right in. But you may be able to figure it out using a Web-based self-assessment tool developed by researchers at Emory University in Atlanta. The tool is now available on several national Web sites, including flu.gov , the Centers for Disease Control and Prevention (CDC), and Microsoft's H1N1 Response Center .

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The online test includes questions like, do you have a fever? Have you been short of breath? Do you have a pain or pressure in your chest that you didn't have before? Were you feeling better and now a fever or cough is returning?

The H1N1 flu , also widely known as the swine flu, is a fairly new influenza virus that has spread around the world. The CDC reports that it first appeared in the United States this past April. By June 11, the World Health Organization categorized it as a pandemic . Because its extremely contagious, hospitals and health care workers have been bracing for the H1N1 to hit hard this fall.

With concerns about the new flu running high , health care providers expect to get slammed with a mounting wave of people rushing in to find out if they have the H1N1 virus.

The online test, dubbed the Strategy for Off-Site Rapid Triage, is designed to help a lot of people figure out if they need to see their doctor or go to a hospital.

"This Web site is carefully designed to encourage those who are severely ill, and those at increased risk for serious illness, to contact their doctor, while reassuring large numbers of people with a mild illness that it is safe to recover at home," Arthur Kellermann, professor of emergency medicine and an associate dean at the Emory School of Medicine, said in a statement. "Hopefully, providing easy-to-understand information to the public will reduce the number of people who are needlessly exposed to H1N1 influenza in crowded clinic and ER waiting rooms, and allow America's doctors and nurses to focus their attention on those who need us most."

Swine Flu Emergency Should Put IT on Alert

Though the H1N1 flu has been declared a national emergency by President Barack Obama, experts say that many companies remain ill-prepared for its potential consequences, which could include employee absentee rates of 40% or more.

While last month's emergency declaration is targeted mostly at helping health care providers and government agencies bypass regulatory requirements to provide critical care, experts say it should also be a red flag for the IT and business communities.

Organizations probably have not allocated enough resources for virtual private networks nor tested VPNs for the fact that 80% of their staff could be working from home," said Al Berman, executive director of DRI International, a training institute that focuses on helping businesses prepare for emergencies. "We ran some tests with companies, and they ran out of TCP/IP addresses in five minutes."

Berman said that many businesses are probably delaying VPN upgrades because of increasing bandwidth costs. For example, he said, DRI recently met with officials of a large insurance provider and found that it would cost the company $1 million to boost bandwidth enough to support 40% of its staff working from home.

The federal government's Flu.gov Web site, managed by the U.S. Department of Health and Human Services, offers guidance to businesses about what to do in the event of a pandemic. Its suggestions range from making sure sick employees stay home to appointing a pandemic coordinator or team to oversee the preparation and implementation of a disaster plan.

Employers should "send a very strong message to employees to stay home if they're sick. No one is that essential," said Kim Elliott, deputy director of Trust for America's Health, a public health advocacy group. "You don't want employees coming in and infecting others to the point where your business shuts down."

The pandemic coordinator or team should monitor employees to ensure that they follow basic rules of hygiene, such as washing their hands, and make sure that face masks are available, according to the Flu.gov Web site.

Elliott said that the planning process should also include an assessment of how the absence of a large number of employees would affect operations, with recommendations on how to keep things running under such circumstances.

"That may mean cross-training employees in some key business functions," Elliott said, citing IT infrastructure maintenance, bookkeeping and accounting duties, and some customer-facing activities.

Businesses should also develop a plan to communicate with municipal agencies, which determine whether bus routes, schools or even businesses need to be shut down, Berman said.
The national emergency declaration came after a weekly U.S. Centers for Disease Control and Prevention report called FluView noted that 43 states are now reporting widespread influenza activity and that H1N1 has caused 1,000 deaths in the U.S.

elevating its health emergency alert status to Phase 6 -- its highest level. At that time, the number of influenza cases was close to 30,000 worldwide. The WHO now says there are 414,000 confirmed cases of H1N1 and that there have been nearly 5,000 H1N1-related deaths.

iPhone App Tracks Swine Flu

A new, free iPhone app from the creators of HealthMap shows the outbreaks of the H1N1 swine flu in your area and elsewhere. The app, called Outbreaks Near Me, finds your location and shows a map with red pins indicating recent outbreaks.

The app updates every hour using reports from more than 30,000 sources. Users can report updates such as school closings through the app. The app was launched last month and now has been downloaded 81,000 times.

Red pins dot the state of California, with heavy concentrations in Los Angeles and the San Francisco Bay Area. Perhaps one of those red pins includes my friend (and many in his East Bay company) who came down with the swine flu a couple of weeks ago.

There are no warning signs, he says. One day you're happily working in your cubicle, and the next you're fighting a fever, vomiting and worse. He lost eight pounds in only a few days after losing his appetite for food and liquids. Luckily, I hadn't caught up with him in a while.

John Brownstein, an assistant professor at Children's Hospital Boston and one of HealthMap's creators, told the Wall Street Journal that the goal of the free app isn't to spark panic, rather to spread the word. To this end, he says, an app solely running on the iPhone isn't ideal. HealthMap is currently developing an app for Google's Android and, later, for RIM's BlackBerry.

Work instructions if you become ill or exposed

Individuals who pose a risk of infecting others as a result of personal illness with H1N1 Flu (Swine Flu) or who have been exposed through direct caregiving may not enter IBM work environments until the risk ceases.

Please be sure Integrated Health Services receives notification as soon as possible about an illness or exposure concern. Immediate action may be needed to evaluate next steps associated with these issues. If you are unable to notify IHS yourself, please contact your manager to handle in your behalf. To reach an IHS representative, please refer to the local IHS team to whom you would report workplace health concerns. Please see below for specific instructions:

Illness
If you have been diagnosed with H1N1 Flu or have symptoms of this illness including fever and cough, sore throat or body aches you are not permitted to come into any IBM work environment (including customer). This restriction applies for a minimum of seven calendar days following the onset of symptoms or at least 24 hours after symptoms have resolved, whichever is longer.

For all other (non-influenza) illnesses and symptoms, the above requirement does not apply. Contact your manager or Integrated Health Services (for IBM employees) and follow the normal return to work practices.

Exposure
Management of H1N1 Flu exposure situations can vary based on the nature of exposure, country requirements and business considerations. In some circumstances, individual risk assessments may be required. Integrated Health Services should participate in those risk assessments.

Travel from an H1N1 Flu affected community/country:
IBM is not requiring anyone to self quarantine at this time as a result of travel.
NOTE: Self quarantine means restricting entry to IBM work environments for 7 calendar days from the last date of exposure (including offices, meetings, customer locations, etc.)
Some countries may impose a period of self quarantine. In such cases, country regulations apply.
Some customers may require a period of self quarantine. In such cases, a business unit decision along with IHS consultation is appropriate.

Caregiver Exposure
If you are directly caring for someone who is ill with H1N1 flu (such as a small child or incapacitated adult) and have had prolonged periods of close face to face contact such as during feeding or bathing the person, it may be possible for you to transmit the illness to someone else just prior to becoming ill yourself. Because of this, you are restricted from coming into an IBM work environment (including customer) for seven days from the date you stop providing direct care. During this time period, you should conduct daily self screening for illness symptoms and fever.
In all other circumstances, exposed individuals may come into the workplace unless otherwise directed by the local/country health department or customer/client instructions. The exposed individual should conduct self screening for illness symptoms and fever daily for seven days from the last date of exposure.

Self screening
Individuals are asked to perform H1N1 Flu illness self screening following exposure to a confirmed or suspected case.

To conduct self screening, please perform the following steps:

Step One: Check whether you have symptoms of illness including fever and cough, sore throat or body aches.

Step Two: Check your temperature using a standard, good quality thermometer following the manufacturer’s instructions.

Step Three: If you have symptoms as described in Step One or you have a temperature greater than 100.4o F or 38o C, you must not go into the workplace.

You should:

Notify your manager that you are unable to report to work.
Contact an IHS representative; please refer to the local IHS team to whom you would report workplace health concerns.
Contact your health care provider for further health instructions, especially if you are at higher risk for complications.
Refer to the guidance in Work Instructions if You Become Ill or Exposed.

Stop the spread of H1N1 Flu

This virus spreads from person-to-person, probably in much the same way that seasonal influenza viruses spread, through coughing and sneezing. Cough etiquette and hand washing are essential to stopping the spread and preventing exposure to the virus.

Wash Hands:

Before eating or preparing food.
After coughing, sneezing, or blowing your nose.
After using restroom facilities.

Handwashing Technique
Wash your hands with soap and water for 20 seconds. Rinse well, with hands held downward. Dry with a paper towel, then use the towel to turn off the faucet.
For health reasons, IBM is only recommending hand sanitizers be present in work areas when soap and water are not available. Though hand sanitizers can be effective in killing some germs, they are less effective than soap and water for removal of germ containing debris on the hands that can be deposited when coughing and sneezing.

Avoid touching your eyes, nose or mouth.
Germs often spread when a person touches something contaminated and then touches their eyes, nose or mouth.

Go home if you get sick at work
Ill individuals should leave the work environment immediately or as soon as possible. Inform your manager or lead that you are ill and need to leave the workplace. Keep at least 1 meter/3 feet from others to protect them from getting sick. Practice cough etiquette. Cover your mouth and nose if coughing or sneezing, using tissues and disposing of them properly. Wash your hands afterward.


For tips on how to stay healthy while traveling, please check the Online Swine Flu Help. For country specific advisories and mandatory quarantine or restrictions on community movement for those who exhibit H1N1 illness symptoms or were exposed to ill travelers, please refer to International SOS Country Guides (see Closures & Quarantine, Airport Screening or Travel Restrictions) or country government agencies such as embassies and state departments.

H1N1 Flu Facts from the World Health Organization (WHO)

H1N1 is now the dominant flu strain in most parts of the world. Studies have detected no signs that the virus has mutated to a more virulent or lethal form.
The pandemic will persist in the coming months as the virus continues to move through susceptible populations.
The symptoms of H1N1 flu are similar to the symptoms of seasonal flu and may include fever, cough, headache, body aches, chills, fatigue, sneezing, sore throat and runny nose. A significant number of people who have been infected with this new H1N1 virus also have reported diarrhea and vomiting.
The overwhelming majority of patients continue to experience mild illness.
At higher risk of serious complications from H1N1 flu are people age 65 years and older, children younger than 5 years old, pregnant women, and people of any age with chronic medical conditions (such as asthma, diabetes, heart disease or immunosuppressed).

While this is a new health problem that may cause concern, there are many actions you can take to protect yourself, your family and the workplace.

Swine flu vaccine ready, enters Europe

Global pharma major Novartis Friday announced it is ready with a swine flu vaccine and has started first deliveries to governments in Europe, giving hopes to people in many parts of the world.
"Novartis has already started first deliveries of pandemic vaccines under quarantine to governments in Europe, despite the initially low yields with the current production seed strain provided by the World Health Organisation (WHO). A new seed strain could provide higher volumes," the company said in a statement issued in Switzerland.


The company announced that Focetria®, the Novartis Influenza A(H1N1) 2009 monovalent vaccine, Friday received a positive opinion from the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA).


The company has started first deliveries of pandemic vaccines under quarantine to European countries, which means the vaccine is now ready with the governments but only after getting the formal approval the governments can start vaccination.


"The positive opinion clears the way for European Union approval in all 27 member states as well as in Iceland and Norway. Today's announcement marks a significant milestone in bringing a pandemic vaccine to market in Europe," the company added.


"Only three months after the declaration of the pandemic by the WHO, Novartis was able to ship the first batches of our pandemic vaccine under quarantine to governments in Europe pending EU approval," said Andrin Oswald, CEO of Novartis Vaccines and Diagnostics.


This CHMP positive opinion paves the way for EU approval, which will allow governments to begin their vaccination campaigns with the goal of reaching more patients before the rapidly spreading virus reaches them, Oswald added.


The pharma major, however, did not give details of the number of doses it has despatched or the countries which have received the first deliveries.


More than 150 countries have been affected by the new millennium's first pandemic. It has taken hundreds of lives across the globe.


In India, the virus has killed 286 people and infected more than 9,200 people till Sep 25.

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

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.

China's mass swine flu vaccination

China is to become the first country in the world to start a mass swine flu vaccination programme for its population following a big surge in the number of cases.

No one's died yet from the virus in China but the authorities there describe the situation as 'grim'.

The big rise coincides with the start of the school year and the approaching winter.

Quentin Somerville reports.