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Swine Flu Update: Going Pandemic

Posted on Jun 19, 2009 by Sergio Ulloa ()  | Tags: Adolfo Lutz, Baxter, CDC, Center for Disease Control and Prevention, CSL, flu, flu vaccine, infection, influenza, Novartis, pandemic, Sanofi, Sinovac, Swine Flu, swine flu vaccine, virus, WHO, World Health Organization

On the 11th of June, the WHO Director-General Margaret Chan announced that after a careful review of the available data and much discussion among both experts in the area and public health officials they have decided to raise the influenza pandemic alert level from phase 5 to phase 6, although the severity of the pandemic has so far only been assessed as moderate. For those of us not well versed in buzzword bingo, what exactly does that mean? Well, influenza pandemics are divided into 6 phases; the first three phases are generally associated with preparedness to deal with an outbreak as well as response planning. Phases 4 through 6 are aimed at signaling the need for appropriate responses to an outbreak and also mitigation efforts. Phases 1-3 are indicative of animal infections and few animal-to-human infections, phase 4 means that sustained human-to-human transmissions have been observed and phases 5 and 6 relate to widespread human infections. To be specific, phase 5 is typified by the observed spread of the virus by human-to-human infections into at least two countries within one WHO region, warning that a full pandemic may be looming on the horizon. Phase 6, which is currently in effect, means that there is a full pandemic going on and is characterized by community level outbreaks of the virus in a country in a different WHO region in addition to phase 5 criteria. So at the moment, our world is in the midst of a global pandemic where swine flu, also known as Influenza A(H1N1), is being communicated from person to person in multiple countries in various regions of the world, Disease vectors at their cutestso of what importance is it when they say the pandemic is only of moderate severity? As it turns out, quite a bit. The moderate assessment is based on three things: firstly, most people recover from the infection without the need for medication or hospitalization; second, while there have been high prevalence rates in some local areas and institutions, the national level of infections are no greater than local seasonal influenza infection rates; finally, while a few medical facilities around the world are being stressed, the vast majority of hospitals and healthcare systems are coping well with the number of patients coming in. As of June 17th, there were a documented 39,620 cases in over 75 countries worldwide with only 167 reported deaths, it is important to keep in mind that the WHO may revise their assessment of the pandemic based on a number of things, including changes in the virus and the limitations of healthcare systems around the world. In other swine flu related news, Brazilian scientists have noticed a new strain of the virus. Agence France-Presse reported on June 16th that after examining samples from a patient in Sao Paulo and comparing it with a sample of the A(H1N1) virus from California, a team of virologists at the Adolfo Lutz Bacteriological Institute isolated the genetic sequence of a variant of the virus, naming it A/Sao Paulo/1454/H1N1. Apparently the mutation in the virus is made up of changes to the specific protein which allows the virus to infect new individuals, raising concerns that the new strain may possibly be more aggressive than the current strain although it is unknown at the moment. Normally influenza infection rates die down in the summer as the virus doesn't cope so well with the increased heat. However, United States health officials are warning that because this year's spring was especially cool and long, the country could experience a year-long flu season where infection rates are low in the summer and then pick up as summer turns to fall. A possibly more worrying piece of news is that there seems to be a large number of infections in healthcare workers in the United States because they haven't been taking proper precautions with patients. A doctor from the U.S. Centers for Disease Control and Prevention (CDC) has said that patients coming into American emergency rooms need to be checked for flu symptoms and healthcare workers need to wear gloves, masks and eye protection when working with possibly infected patients, as infected workers may transmit the virus to other vulnerable patients elsewhere in the hospital. Influenza VirionOn the lighter side, due to heightened awareness of a possible flu pandemic after the bird flu outbreak in Hong Kong 12 years ago, more funding and attention has been funneled into vaccination efforts and numerous pharmaceutical companies have begun work on a swine flu vaccine for the A(H1N1) virus already. A number of companies including Baxter International, CSL Ltd., Chinese company Sinovac Biotech, Novartis AG and Sanofi-Aventis SA are all working on vaccines. Sinovac has said it can finish clinical trials by the end of July, while Baxter indicates it could be able to start filling orders for a vaccine next month. Most companies are expected to make a vaccine available around the autumn time. Sanofi-Aventis has said that it will donate 100 million doses of it's vaccine to the WHO in order to ensure that poorer countries have access to the vaccine during the pandemic. On the other hand, Novartis, the Basel, Switzerland based country has previously decided that it will not donate vaccine doses to the WHO and is instead looking at a tiered system of pricing to make sure that both rich and poor countries will have access to the company's vaccine. During this time it is important to take care of yourself and those around you. Make sure that you wash your hands frequently and if you feel flu-like symptoms, be sure to wear a mask and make a visit to the doctor as soon as possible. If you develop symptoms, or otherwise think you may have contracted the virus, please do not go to work, school or crowded places, avoid contact with others and be sure to cover your mouth with a tissue when coughing. If a tissue is unavailable cover your mouth as much as possible with the crook of your elbow. For an interesting graphic showing the day by day progression of the virus across the world, please click here.
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