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Swine Flu (H1N1)

katek
  • By katek
  • Posted July 13, 2009 at 2:44 pm · 79 replies
  • In Open discussion
  • Shared with the public
  • Edited September 1, 2009 at 3:56 pm
3 Recommendations

Although the media are no longer covering swine flu much, there are reports that it could return in August approximately with greater ferocity.

I found two links that people may find useful:

(1) CDC Updates

http://www.cdc.gov/h1n1flu/

(2) WHO Updates

http://www.who.int/csr/disease/swineflu/en/

The CDC link has a map that shows H1N1 flu activity by state. There are many areas of the country where it is still active.

According to WHO, 170 people in the U.S. have died from it.

Stay safe!

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79 replies

mygirlsmom

We have an outbreak in my community. I don't quite know how to protect ourselves further than avoiding most public places, and that includes park equipment for the time being. scrubbing hands, the usual. And of course listening for coughing people on the commuter train - LOL! I'm a seat jumper, I'll admit it!
I know that the elementary kids have quite a number of cases in my town, that it spread at either a camp or something - pretty scary.

katek

Hopefully, people who are sick will practice good hygiene and wash their hands before touching their grocery carts, door handles, etc.

I return to teaching at the end of August. The graduate students practice common sense (e.g., don't come to class when you are coughing up your lungs), but the undergraduates are another story...

SpeasHill

There have been a few cases in my teeny, tiny country town. Turns out we aren't as isolated as I feel out here in the country!
Interestingly, I'm in Atlanta right now - taking the kids on a mission trip - and the VERY first thing they did when we got here was take everyone's temperature, since there have been so many outbreaks at residential summer camps.
(And, just in case you are wondering, Becca and I are not staying at the church with the kids. I'm in a posh Buckhead house (a church member's) while my husband and my kids roof in Atlanta in July. This is the best mission trip EVER! ;) )

EvinsMom

Yeah, Thanks for posting.
This was my understanding when the first wave hit- that it was a milder version of the second, and more dangerous version, to hit in the fall.
Basically, it stays out there and gets stronger/ harder to fight.

Stay well everyone!

lilfiery

If I knew my son would survive it now--I would rather get it over with (rather than in the fall when its supposed to get worse, and beds in hospitals might be an issue)......but that being said, I am extremely petrified of this disease.

People are selfish and not very educated about this flu. We know a girl who had a sore throat, fever, cough etc and still insisted on working (a very public job where she was around tons of people). People will not stop going to work unless they were paid to do it...and then there would be much abuse of that as you can imagine.

My son is having surgery tomorrow--and the hospital he's going to had an outbreak last week--same floor as the surgery area. I'm worried, but probably better to get his surgery done now...rather than later if this thing blows up.

can't wait for the vaccine, but now they are having some issues with production apparently.

katek

My understanding is that catching it early doesn't prevent someone from catching it again during the second round when it has mutated.

I'm pretty sure that my son had it during the first round back in early May. He wasn't tested. The doctor had us keep him home and hydrated. Foster daughter caught it too, but she rebounded right away. It took my son over a week to recover. My mom had it first, and she was sick for 1.5 weeks.

M-and-D-Mommy

This is so scary! What scares me more is that we are forced to depend on others to think about other people. Not many people are good at that, especially when it comes to illness. I actually don't know anyone (personally) that seems to be tooooo concerned with it and that is how it will spread like wildfire!!! :)
Good luck everyone!!!

Thanks for the post Kate!!

How was your vacation/trip??? How did the little ones do on the plane???

Brayden123

This terrifies me since I am a nurse at a big childrens hospital in Chicago! I go back to work in about five weeks and I know there are cases there right now! Ugh!!! Am going to have to be beyond cautious!!!

katek

The trip was good...although "vacationing" with two toddlers is a lot of work!

My FIL has a beautiful property in Oregon in the hills of farm country. Very pretty. The house, unsurprisingly, was not exactly baby-proof, so we had to stay extra vigilant.

The kids were as good on the plane as one could reasonably expect from two toddlers. We did break out the laptop for a DVD toward the end of the trip home to keep Henry happy. It was a long time for toddlers to sit still! :-)

katek

More information from: http://www.azstarnet.com/sn/health/301382.php

Flu spread continues; bump expected when school season begins
Los Angeles Times
Tucson, Arizona | Published: 07.18.2009

The pandemic A(H1N1) 2009 influenza virus unexpectedly is continuing to spread easily through the United States during the summer months, and health authorities expect a bump in transmission in about six weeks, because school goes back into session.

The increase will occur perhaps two or three months earlier than is normally seen with seasonal flu.
"Every year, there is an increase in flu when children go back to school," Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases said Friday in a telephone news conference, noting that viruses are being shared in close quarters.

"This year, it is already circulating in summer camps, military units and so forth, so we are expecting when school opens we will see (a bigger than normal) increase."

Schuchat said she thinks the unusually high rate of transmission during the heat and humidity of summer, which normally sharply reduces transmission, may be due to the large number of Americans with no resistance to the virus from previous exposure.
But there are "no data," she said, to suggest why continued transmission is occurring.

As of Friday morning, the CDC had reported more than 40,000 laboratory-confirmed cases of the virus (commonly known as swine flu), 4,800 hospitalizations and 263 deaths. Experts, however, believe that more than 1 million Americans have been infected.
The World Health Organization, which has reported nearly 100,000 confirmed cases worldwide, said Thursday that it would stop counting cases because it required too much unnecessary work by health authorities.

A week ago, the agency said it recommended local agencies no longer test for the virus unless they had not had cases previously or there was an unusual outbreak.

Schuchat said the CDC probably also would stop reporting cases soon, focusing instead on more traditional measures of spread, such as pneumonia cases and deaths.

katek

See: http://news.yahoo.com/s/ap/20090725/ap_on_he_me/us_med_swine_flu

Swine flu could hit up to 40 percent in US

By MIKE STOBBE, AP Medical Writer

ATLANTA – In a disturbing new projection, health officials say up to 40 percent of Americans could get swine flu this year and next and several hundred thousand could die without a successful vaccine campaign and other measures.

The estimates by the Centers for Disease Control and Prevention are roughly twice the number of those who catch flu in a normal season and add greater weight to hurried efforts to get a new vaccine ready for the fall flu season.

Swine flu has already hit the United States harder than any other nation, but it has struck something of a glancing blow that's more surprising than devastating. The virus has killed about 300 Americans and experts believe it has sickened more than 1 million, comparable to a seasonal flu with the weird ability to keep spreading in the summer.

Health officials say flu cases may explode in the fall, when schools open and become germ factories, and the new estimates dramatize the need to have vaccines and other measures in place.

A world health official said the first vaccines are expected in September and October. The United States expects to begin testing on some volunteers in August, with 160 million doses ready in October.

The CDC came up with the new projections for the virus' spread last month, but it was first disclosed in an interview this week with The Associated Press.

The estimates are based on a flu pandemic from 1957, which killed nearly 70,000 in the United States but was not as severe as the infamous Spanish flu pandemic of 1918-19. The number of deaths and illnesses from the new swine flu virus would drop if the pandemic peters out or if efforts to slow its spread are successful, said CDC spokesman Tom Skinner.

"Hopefully, mitigation efforts will have a big impact on future cases," he said. Besides pushing flu shots, health officials might urge measures such as avoiding crowded places, handwashing, cough covering and timely use of medicines like Tamiflu.

Because so many more people are expected to catch the new flu, the number of deaths over two years could range from 90,000 to several hundred thousand, the CDC calculated. Again, that is if a new vaccine and other efforts fail.

In a normal flu season, about 36,000 people die from flu and its complications, according to the American Medical Association. That too is an estimate, because death certificates don't typically list flu as a cause of death. Instead, they attribute a fatality to pneumonia or other complications.

Influenza is notoriously hard to predict, and some experts have shied away from a forecast. At a CDC swine flu briefing Friday, one official declined to answer repeated questions about her agency's own estimate.

"I don't think that influenza and its behavior in the population lends itself very well to these kinds of models," said the official, Dr. Anne Schuchat, who oversees the CDC's flu vaccination programs.

The World Health Organization says as many as 2 billion people could become infected in the next two years — nearly a third of the world population. The estimates look at potential impacts in a two-year period because past flu pandemics have occurred in waves over more than one year.

Swine flu has been an escalating concern in Britain and some other European nations, where the virus' late arrival has grabbed attention and some officials at times have sounded alarmed.

In an interview Friday, the WHO's flu chief told the AP the global epidemic is still in its early stages.

"Even if we have hundreds of thousands of cases or a few millions of cases ... we're relatively early in the pandemic," Keiji Fukuda said at WHO headquarters in Geneva.

The first vaccines are expected in September and October, Fukuda said. Other vaccines won't be ready until well into the flu season when a further dramatic rise in swine flu cases is expected.

First identified in April, swine flu has likely infected more than 1 million Americans, the CDC believes, with many of those suffering mild cases never reported. There have been 302 deaths and nearly 44,000 laboratory-identified cases, according to numbers released Friday morning.

Because the swine flu virus is new, most people haven't developed an immunity to it. So far, most of those who have died from it in the United States have had other health problems, such as asthma.

The virus has caused an unusual number of serious illnesses in teens and young adults; seasonal flu usually is toughest on the elderly and very young children.

___

Associated Press writer Frank Jordans in Geneva contributed to this report.

katek

The U.S. Department of Health and Human Services (HHS) has a website on the flu. See:
http://flu.gov/

They just opened a contest to the public for creating public service announcements (PSAs) on protecting people from the flu. The prize is $2500. They are looking for PSAs 15, 30, or 60 seconds long.

I know that there are several people on this website with creative skills (as demonstrated by your various videos of your kids!). If you are interested in trying your hand at creating a short video to educate others, here's your chance! The winners will be aired nationally. For details, see: http://flu.gov/psa/index.html

JamiesMom

Thanks for posting the articles, Kate. I'm going back to teaching in September, too. You're right; the graduates will play it safe, but the undergrads (and I primarily teach freshman) act like they're still in elementary/middle/high school in terms of practicing smart hygiene. I'm pregnant again, though, and it's possible that they'll put me on disability for fall/spring (I'm due in January, but getting cervix length checked today). I confess, I'm almost excited about the idea, even though it'll make the budget tight. I'd rather stay away from the students from the dormitory / bacteria and virus incubator. I've also considered adding a paragraph in my syllabi about staying healthy during the semester and keeping the professors the same way. :) What do you think?

katek

JamiesMom,

I was contemplating something in the syllabus too!

Working with undergrads can be hard b/c on the one hand, I feel like students should present doctor's notes in order to reschedule exams and/or get extensions on projects. I've had students lie in the past. I feel like firm dates are an important life tool to learn and it keeps things fair between students. But that the same time, I know that undergrads aren't like to go see a doctor if they "just have a cold." And I don't want to create rules that would make it more likely for them to come to class sick...especially this flu season! What policies do you use for your classes?

katek

BTW, congratulations on your pregnancy, JamiesMom! That's very exciting!

Anna5

I am not looking forward to a new school year-I am going to have 1 high school student,1 middle and 3 elementary where my 5 year old is starting kindergarten.Its going to be a germ melting pot.I think we have to go back to strict sanitazing routine like the one we used when my preemie was born.Thanks katek for all the info on the flu,its good to be prepared.

katek

See: http://www.msnbc.msn.com/id/32184356/ns/health-swine_flu/

Pregnancy likely to be swine flu shot priority
Federal advisory panel to determine who should be first to get vaccines
By AP

ATLANTA - Swine flu has been hitting pregnant women unusually hard, so they are likely to be among the first group advised to get a new swine flu shot this fall.

Pregnant women account for 6 percent of U.S. swine flu deaths since the pandemic began in April, even though they make up just 1 percent of the U.S. population.

On Wednesday a federal vaccine advisory panel is meeting to take up the question of who should be first to get swine flu shots when there aren't enough for everyone. At the top of the list are health care workers, who would be crucial to society during a bad pandemic.

But pregnant women may be near the top of the list because they have suffered and died from swine flu at disproportionately high rates.

"Are they more at risk for severe disease? That's the issue," and it appears they are, said Dr. Denise Jamieson, an epidemiologist with the U.S. Centers for Disease Control and Prevention.

Pregnant women's risk from swine flu has been a raging topic in Europe, following the contentious suggestion this month by British and Swiss health officials that women should consider delaying pregnancy if they can.

Most health officials call that advice unwarranted — since pandemics can last more than one year — but have agreed that the health risks are significant. In a recent report, World Health Organization experts found that pregnant women appear to be "at increased risk for severe disease, potentially resulting in spontaneous abortion and/or death, especially during the second and third trimesters of pregnancy."

However, so far, WHO has not recommended that pregnant women get priority vaccinations.

Now doctors are waiting to see what's decided by the Advisory Committee on Immunization Practices, whose guidance usually is accepted by the CDC and influences doctors and U.S. insurance coverage.

Immunity may be passed to child
For more than a decade, the committee has recommended that pregnant women get vaccinated for seasonal flu, which is considered a serious threat even to pregnant women who are young and healthy. Pregnant women are unusually vulnerable — especially in the third trimester — due to changes in the lungs and immune system that make it harder for them to shake off respiratory infections, said Dr. Kevin Ault, an Emory University obstetrician.

CDC data indicate swine flu is at least as dangerous. Of 302 U.S. deaths attributed to swine flu to date, the CDC has detailed information on 266 of them. The agency has found that 15 of the 266 were pregnant women — or about 6 percent.

The first American with swine flu to die was a pregnant woman in Texas. Judy Trunnell, 33, died May 5 after slipping into a coma and giving birth to a healthy baby girl, delivered by Cesarean section.

Some infected pregnant women have other health problems. Trunnell, for example, also had asthma. But many of the pregnant women who died were considered relatively healthy, suggesting pregnancy itself is a significant risk, Jamieson said.

"I think the whole concept that this flu only affects pregnant women with underlying medical conditions is incorrect," Jamieson said.

Experts believe an effective vaccine would benefit not only a pregnant woman but also her unborn child.

Infants, whose immune systems are weak, should not get a flu shot until they are at least 6 months old. So whatever immunity they have is passed on to them by their mothers, doctors say.

The belief in the protective powers of a mother's vaccination on their unborn children was demonstrated in a study of women in Bangladesh published last year in the New England Journal of Medicine. It found that flu shots given to pregnant women reduced flu in infants by 63 percent.

Only about 15 percent of pregnant women get seasonal flu shots, experts noted, so it's not clear how many will get the new shot.

Some women avoid regular flu shots, worried about possible risks to the fetus, but studies have not shown any increased dangers from the shot.

Until recently, many obstetricians haven't offered them, choosing to avoid the expense of buying and storing vaccine and the hassle of trying to convince reluctant patients, said Dr. William Schaffner, a Vanderbilt University flu expert.

"Obstetricians are only now getting with the program and are growing comfortable with administering flu vaccine," he said.

Not a ‘major concern’ yet
It's not clear that the demand for swine flu shots would be much greater. Pregnant patients haven't expressed much concern about swine flu, said the CDC's Jamieson, who is also an obstetrician seeing inner-city patients at Atlanta's Grady Memorial Hospital.

"It hasn't been a major concern," viewed as a relatively mild illness. They worry more about economic concerns — "how to take care of the baby, how to get food to eat and how to get safe and secure housing," Jamieson said.

So far, swine flu has likely infected more than 1 million Americans, the CDC believes, with at least 300 deaths.

The United States expects to begin testing swine flu vaccines on some volunteers in August, and predicts 160 million doses may be ready by October.

Tamiflu-resistance
As countries scramble to develop a vaccine to stop the virus, Japan found a third case of Tamiflu-resistant swine flu in a man who had taken the drug to prevent infection, the Tokushima prefectural office said Tuesday.

Just six cases of Tamiflu-resistant swine flu have been reported worldwide.

In a statement, the prefectural health department said the man in his 30s was given Tamiflu after his colleague was infected with the virus this month.

The Tamiflu-resistant strain does not appear to have spread beyond the man, who has recovered, the prefectural health department said.

Preventive use of Tamiflu has occasionally given rise to resistant viruses, including those of seasonal flu.

Denmark, Hong Kong and Canada also have reported one case each of Tamiflu-resistant swine flu.

3xpreemiemom

Swine flu really triggers my freak-out response. I've been following it fairly closely and am pretty worried about what's going to happen when fall rolls around. I am about as scared of the vaccine as I am of the flu itself. I'm hoping they have time to do adequate clinical trials before they start having everyone roll up their sleeves.

JamiesMom

Kate,

I teach at a smaller private university, so my class sizes tend to be smaller and the students tend to be more honest (although in recent years I've seen that slowly reversing with each generation of students). Since I have the smaller ratio, it's easier for me to keep tabs on the individuals. For example, my student worker lives in the dorms and can usually tell me what wings have been hit with flu/colds. Still, my syllabus policy requires a doctor's note or other confirmation for excused absence. I am flexible about it, but at the beginning of each semester I put the fear of God in my students regarding unexcused absences by memorizing their names. :) This way, when they really do have the flu, they take every possible step to prove to me that it's real (sending friends with homework, e-mailing for several pages, etc.). I tend to give them the benefit of the doubt and excuse it, but since my comp classes are freshman, for the most part, they don't know that and are very careful about "proving" illness. I still have to take it on a case-by-case basis, but if you have larger student/teacher ratios I know that can be hard. I'd still rather be horribly strict up front and on paper and then "mellow" over time than allow the constant absences that seem to be so popular now. My upper-division classes aren't such a worry; they tend to be older, sometimes married students and they don't have as much exposure as the younger kids do.

Sorry, I just realized that was running on, but none of my colleagues have preemies and they tend to think I'm a little paranoid and should encourage the students to attend as long as they aren't vomitting on the students sitting next to them. :-P It's nice to know someone else is concerned about it.

All that said, and the director of Maternal-Fetal Medicine at Loma Linda says it's time for me to work on some publishing and conference organization from home rather than teach this semester. I won't have to worry about the contagion as much, but I will miss work. (What do you personally think about the swine flu vaccine for pregnant women?) The grad students have promised to e-mail me MA thesis drafts and various updates on academia while I'm at home, though, so I'll survive. :) The baby is fine so far, but they are still concerned about my cervix length and I'll be doing two-week appointments from now on with diagnostic U/S.

Oh, what I had considered putting in the syllabus wasn't so much a policy change as a general warning and "FYI" paragraph. If the students understand that a professor is concerned for their health and his/her own, I think they'll be a little more careful. At least, I hope that would still be the case. Like I said, I'm concerned about the maturity and common sense of recent batches of students.

katek

http://www.msnbc.msn.com/id/32320320/ns/health-swine_flu/?ns=health-swine_f lu

Early flu shot season may come with 3 jabs
Most people may need one shot for seasonal flu, two more for swine

AP
updated 4:39 p.m. MT, Thurs., Aug 6, 2009

ATLANTA - Get ready to roll up your sleeve three times for flu shots this fall.

That's right, three times. This year's flu season is shaping up to be a very different one. Most people will need one shot for the regular seasonal flu and probably two others to protect against the new swine flu.

Experts suggest you get that first shot as early as this month — if you can find it.

"We'd like to get to Job 1 and get most of it done," said Dr. William Schaffner, a Vanderbilt University flu expert, referring to seasonal flu vaccinations.

"Get it done before we start to tackle Job 2," the more complex task of swine flu vaccinations, he added.

The five vaccine manufacturers that supply the United States are finishing up production of seasonal flu vaccine earlier than usual. Health officials say they expect about half of the more than 120 million doses of seasonal vaccine to be available by the end of this month. Most of the rest are due out by the end of September. Some manufacturers report that distributors are quickly buying up supplies.

Expected in the fall
Those five companies — including one that makes a nasal spray version of flu vaccine — are the same ones making the new swine flu vaccine. They are on track to start delivering the first batches of that in September, but the bulk of it isn't expected until late October or November, health officials say.

That's sparked questions about how all this is going to work.

Officials want to get as many people as possible vaccinated against both forms of flu, but a lot of that depends on consumers and how many trips they'll be willing to make to get shots.

Why can't you get one shot for all — or maybe just two?

The reasons have to do with logistics and caution.

Scientists believe the swine flu vaccine will be most effective if given in two doses, about three weeks apart. Also, they don't think the seasonal and swine flu vaccines can be combined into one syringe or vial and still be effective, so they've got to be administered as separate doses, even if it's during the same appointment.

But it's not a matter of just giving both to whoever comes in. Supplies are expected to be limited, so the federal Centers for Disease Control and Prevention has two different lists for who should be first to get the seasonal flu shot and who should be first to get the swine flu shot.

For the regular flu vaccine, elderly people, health care workers and pregnant women are among the priority groups. For the swine flu vaccine, health care workers and pregnant women are on the list but not older people, who seem to have some immunity to swine flu.

If all the flu shots were given at about the same time, it could mean a mash of people, some of whom should be among the first to get one shot and not the other.

"I think it's safe to say we expect some confusion," said Kristine Sheedy, a CDC communications specialist.

Then, there are safety questions.

Health officials are haunted by the swine flu vaccine campaign in 1976, which was stopped after unexpectedly high numbers of patients suffered a paralyzing condition called Guillain-Barre Syndrome. While it's not clear the vaccine was to blame, health officials want to carefully monitor people who get the new swine flu vaccine for any problems.

Scientists are just beginning to test the safety and effectiveness of the new swine flu vaccine, work that is expected to take months. If the seasonal flu and swine flu vaccines were given at the same sitting and some people developed health problems, it would be hard to single out which vaccine caused the problem, or whether it was the combination of them.

"How you're going to separate that out — that's a doozer," said Dr. Samuel Katz, a Duke University vaccines expert, who was a developer of the measles vaccine.

So the government is looking at three shots, preferably over three visits.

That's daunting. Over the years, the public hasn't been great about getting even one flu shot: Just one in three U.S. adults got flu shots last year, CDC data indicate.

"To come two or three times? That's expecting a lot, of public response," said Katz.

Health officials traditionally kick off an autumn vaccine campaign against seasonal flu in late September or October with a news conference in Washington D.C. But this year, the news conference — which features the CDC director — has been moved up to Sept. 10.

Unofficially, the push for seasonal vaccinations begins even sooner, some health officials said.

"As soon as it becomes available, we'll be encouraging people to get it," said Carol Schriber, a spokeswoman for the North Carolina Department of Health and Human Services.

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