The H1N1 pandemic is over and the global outbreak turned out to be much less severe than was feared just over a year ago, the head of the World Health Organisation (WHO) said today.
WHO director-general Margaret Chan once again rebutted criticism that the United Nations agency had hyped the first pandemic in more than 40 years, whose mildness left some Western governments holding huge stockpiles of unused vaccines.
The Hong Kong public health expert said the world had been lucky the H1N1 virus had not mutated into a more deadly form and that a safe vaccine developed in record time remained effective against it.
“We are now moving into the post-pandemic period. The new H1N1 virus has largely run its course,” Chan (picture) said.
The swine flu pandemic, which has cost the nation more than £1billion, was declared over yesterday.
With the number of new cases plummeting, health chiefs announced the 24-hour flu helpline will close down next Thursday.
Critics said the seven-month outbreak had been mishandled by ministers and health officials, who had made a flawed assessment of the threat.
Swine flu has killed 411 Britons, with 124 more still in hospital - yet the 5,000 cases a week are far below the average for seasonal flu.
Chief Medical Officer Sir Liam Donaldson had warned the pandemic might claim 65,000 lives and Health Secretary Andy Burnham said 100,000 could be struck down with the disease every day.
Total cases stand at 800,000 so far. Around the world, an estimated 14,000 deaths have been reported - a fraction of the number dying each year from ordinary flu.
The Government is thought to have ordered tens of millions of doses of vaccine.
So far only 4.25million have been administered to priority groups in England.
Sir Liam is still urging the vulnerable to have the jabs.
He insists the vast cost of tackling the pandemic has been justified, from the £1billion cost of vaccines and antivirals to the £10.4million spent on publicity.
The National Pandemic Flu Service, which cost a further £13.5million to run, allowed patients to bypass their GP and collect antiviral drugs after a telephone assessment.
Launched in July last year and employing 1,500 call centre staff, it led to 1.1million courses of antivirals being administered to patients - many of whom never had swine flu, according to research.
Anyone suspecting they have swine flu can still get antiviral drugs from their GP, while those in at-risk groups, including children under five, can receive a vaccination.
Sir Liam said: 'When the virus returns I would very much like to see young children already protected.
'From now on, most deaths from the pandemic flu virus should be regarded as potentially preventable.'
A spokesman for the Department of Health said: 'Our priority remains to vaccinate those most at risk from swine flu, as people are still in hospital from the virus.
'This is the first time we have had a vaccine to protect people while a pandemic virus has been circulating, so it has undoubtedly helped us save lives.'
However, the bumper revenues being reported by vaccine manufacturers - £4billion in windfall profits is predicted - have led to claims that the World Health Organisation fell under the influence of the industry when it declared a pandemic last June.
Matthew Elliott of the Taxpayers' Alliance said: 'The Government's reaction to swine flu has proved to be excessive and poorly managed.
'It beggars belief that they could have signed so many massive contracts with such a flawed assessment of the threat.'
But John Oxford, professor of virology at Bart's and The London Hospital, defended the flu strategy.
'Swine flu is behaving in a classic Darwinian fashion - the survival of the fittest - and has already displaced 98 per cent of the other flu viruses,' he said.
'My worry is that when it gets into the elderly next year, we could see many more deaths.
'We should be proud that Britain responded in a way that prevented many more cases and deaths.'
Over at last: The National Pandemic Flu Service will be stood down
Pandemic status: Students quarantined in China chat with a health worker in Beijing
Drug companies manipulated the World Health Organisation into downgrading its definition of a pandemic so they could cash in on a swine flu outbreak, it is claimed.
An inquiry heard yesterday that the WHO allegedly softened its criteria for declaring a H1N1 flu pandemic last spring - just weeks before announcing there was a worldwide outbreak.
Critics said the decision was driven by pharmaceutical companies desperate to recoup the billions of pounds they had invested in researching and developing pandemic vaccines after the bird flu scares in 2006 and 2007.
As a result, millions of people have been vaccinated against a mild illness, and money that could have been used to prevent and treat major killers such as heart disease has been squandered.
The claims, which emerged during the first of several Council of Europe hearings into the handling of the swine flu pandemic, were strongly rejected by the WHO.
Following the organisation's declaration of a pandemic, the Department of Health warned of 65,000 deaths, set up a special advice line and website, and suspended normal rules so anti-flu drugs could be given without prescription.
But with just 250 or so deaths in Britain and 14,000 worldwide, the WHO is being asked to account for its actions.
The Government is now trying to off-load millions of jabs it ordered at the height of the scare. Sources say it is even considering giving some doses away for free.
Wolfgang Wodarg, former head of health at the Council of Europe, the Strasbourg-based 'senate'
responsible for the European Court of Human Rights, said vaccine contracts were put in place in 2007, when it was feared the more lethal bird flu virus would mutate into human form.
Drug companies, which spent up to £2.5billion developing a vaccine, then pushed their interests within the WHO, leading to the definition of a pandemic being softened and an outbreak declared.
He told the hearing: 'It was stated in panic- stricken terms that this was a flu that could threaten humanity and a great number of humans could fall ill.
'This is why billions of dollars of medications were bought.
Dr Wodarg, an expert on the spread of disease, said that the change in definition made it possible for a worldwide pandemic to be declared and for the pharmaceutical companies to cash in.
Also giving evidence, Professor Ulrich Keil, a WHO adviser on heart disease, said the decision had led to a 'gigantic misallocation' of health budgets.
'We know the great killers are hypertension, smoking, high cholesterol, high body mass index, physical inactivity and low fruit and vegetable intake,' he said.
'In spite of all these facts, governments instead wasted huge amounts of money by investing in pandemic scenarios whose evidence base is weak.'
But Dr Kieji Fukuda, the WHO's top flu expert, rejected the allegations. 'We do not wait until (these global virus outbreaks) have developed and we see that lots of people are dying,' he said.
'What we try to do is take preventive actions. Our purpose is to try to provide guidance, to reduce harm.'
1. High temperature, tiredness and lowered immunity
2. Headache, runny nose and sneezing
3. Sore throat
4. Shortness of breath
5. Loss of appetite, vomiting and diarrhoea
6. Aching muscles, limb and joint pain
Source: NHS
Dr Margaret Chan says avian flu is more of a problem than swine flu The head of the World Health Organisation (WHO) has warned the global swine flu pandemic is not yet over and the virus could still mutate.
Dr Margaret Chan said it was important to "guard against complacency" despite signs the disease had peaked in North America and parts of Europe.
She said the virus was still active in countries including India and Egypt.
More than 11,500 people are believed to have died in more than 200 countries and territories because of swine flu.
However Dr Chan said it would take at least two years before a true death toll could be established.
The WHO's director general said the US, Canada and the UK were among those countries where the worst of the swine flu outbreak had appeared to have passed.
Danger
But she added: "It is too premature and too early for us to say we have come to an end of the pandemic influenza worldwide."
She said experts needed to continue monitoring the pandemic for another six to 12 months as it could mutate into a more dangerous strain.
"We will watch this virus with eagle's eyes," she said.
Dr Chan said it was fortunate the pandemic had been milder than expected.
"The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news in a decade," she said.
Millions of people are believed to have recovered after contracting the virus and displaying few symptoms.
She said the demand for swine flu vaccinations in some European countries had been lower than expected and WHO was investigating whether superfluous vaccines could be sent to developing countries.
Dr Chan said drug makers and countries promised to donate nearly 190 million vaccine doses to WHO, with the first doses of the donated vaccines to be distributed in Azerbaijan, Mongolia and Afghanistan next month.
However she admitted she had not yet had a vaccine but said she would have it soon.
She said that although countries are now better prepared to cope with a global disease outbreak, people still had to be aware of the dangers of bird flu (H5N1).
She said this was more toxic and deadly than swine flu and that many countries remained ill-prepared for mass outbreaks of this virus.
"The world is not ready for a pandemic to be caused by H5N1," she said.
The head of the World Health Organization (WHO) warned on Tuesday that the A/H1N1 pandemic influenza is not over yet and the world needs to continue monitoring the evolution of the disease in 2010.
"It's too premature, too early for us to say we have come to an end of the pandemic influenza worldwide," Dr Margaret Chan told a news conference at the WHO headquarters in Geneva.
It's true that many countries in the northern hemisphere have passed the peak of the pandemic, notably in the United States, Canada and parts of Europe, but on the other hand there are still intensive influenza activities in countries like Egypt and India, Chan said.
The current pandemic caused by the H1N1 flu virus has been described as "moderate", but scientists cannot rule out the possibility that the virus could mutate and become more dangerous given the fact that flu virus are highly unpredictable.
So "it would be prudent and appropriate for the WHO together with our members’ states to continue to monitor the evolution of this pandemic for the next six to 12 months," Chan said.
So far nearly 12,000 people worldwide have been killed by the A/H1N1 influenza since the disease first emerged in April, according to an update released by the WHO last week.
But Chan noted that was a laboratory confirmed number, and it actually underestimates the real number of deaths caused by the pandemic.
"Many countries don't have the capacity for surveillance, for diagnosis and for confirmation. So there would be some deaths in some countries that are not reported," Chan said.
According to the WHO chief, the handling of the A/H1N1 pandemic has shown that the world is much better prepared now than five years ago to deal with such diseases. But there are still many gaps in the health systems in many countries.
She warned that the world is not yet ready for dealing with a pandemic caused by the H5N1 bird flu virus, which is "much more toxic and deadly" than the H1N1 virus.
"I just wish that the world does not have to deal with a pandemic ignited by a much more toxic and deadly virus, the avian flu virus H5N1," Chan said.
Vaccine are made from old technology as lack of funding earlier hamper development.Vaccines are sold cheap but produced in millions. Current tecnology are old depends on injecting virus into egg. Latest technology range from using kidney cells of dogs,monkey , e coli cells and even the virus dna .Read more below.
After a lethal bird flu virus emerged in Asia, U.S. officials launched an intense effort to build new defenses against a pandemic, including replacing an antiquated vaccine system, which depends on millions of chicken eggs.
But six years later, as Americans from Washington to California line up to get inoculated against the swine flu, the slow progress toward developing better ways to make a vaccine has become glaringly obvious.
This lag and the shortage of H1N1 vaccine have focused attention on the status of government efforts to develop state-of-the-art techniques to make flu and other vaccines, including those needed to protect against bioterrorism, and the nation's dependence on a process that is notoriously slow and unreliable.
Several new technologies are showing promise. Spurred by $487 million in federal funding, a sprawling new vaccine factory is opening in North Carolina Tuesday that will produce shots using dog cells instead of chicken eggs. A Connecticut biotech company has also applied to sell a vaccine employing a radically different approach involving a genetically engineered virus infecting insect cells -- a strategy a Rockville firm is testing to inoculate people against the swine flu in Mexico. Dozens of other high-tech approaches are also moving through the pipeline.
While several companies are trying to ready their new techniques in case the H1N1 pandemic worsens, most of these remain years away from contributing significantly to the world's capacity to respond to a deadly new pathogen.
"If this pandemic had come next year, we might have had some of these vaccines licensed and we would have been able to use them -- our investments might have borne fruit," said Robin Robinson, of the Health and Human Services Department. "But unfortunately they didn't help us this year. Others still have a ways to go."
The most immediate solution to the vaccine shortage would be adjuvants -- compounds that boost the immune response, allowing limited stock to be stretched into more doses. H1N1 vaccine with adjuvants is available in Europe, Asia, the Middle East, Canada and Mexico. The United States has decided against using adjuvants because the Food and Drug Administration has not fully reviewed them. Officials worried that a new product would make people even more nervous about the inoculation.
'Old fragile unpredictable technology'
For decades, flu vaccine has been produced by identifying which strains of flu virus were most likely to be circulating, tinkering with microbes in the laboratory to create "seed" virus, injecting that virus through the fragile shells of newly fertilized chicken eggs and waiting several days for the microbes to grow.
The process takes six to nine months and is highly unpredictable. The H1N1 seed virus initially grew inside the eggs at only about a third to a quarter of the expected rate, accounting for most of the lag in production.
"It's a time-honored but nonetheless fragile technology," said Anthony S. Fauci of the National Institute of Allergy and Infectious Diseases.
In addition, the process relies on having access to millions of eggs -- each egg typically produces one to three doses of vaccine. If the next pandemic is caused by a virus that kills birds, like the H5N1 avian flu virus that emerged in 1997 in Hong Kong and reemerged in 2003, any process dependent on chickens would be vulnerable.
Pharmaceutical companies, however, have had little incentive to invest in new technologies. Flu vaccine is relatively cheap and the market is capricious -- millions of doses often end up being discarded because of tepid demand. The long, expensive process of getting new vaccines approved creates another disincentive.
"We're behind the curve in embracing new technology because we're exceedingly cautious," said Scott Gottlieb, a former deputy FDA commissioner now at the American Enterprise Institute.
But in 2006 the federal government awarded $1.3 billion to six companies to develop flu vaccines using cells to grow the virus instead of eggs, although three recipients have dropped out or stalled.
"You just take the cells out of the freezer right away and ramp up production," said Andrin Oswald of Novartis. The Swiss company already makes flu vaccine using dog kidney cells for Europe and Japan at a factory in Germany; on Tuesday, it will cut the ribbon on a massive new facility in Holly Springs, N.C., that will eventually be able to produce 150 million doses of vaccine in six months for the United States. But the factory will not be ready to start making vaccine until 2011 at the earliest.
Baxter International won approval last month to sell an H1N1 vaccine in Europe that uses a decades-old line of African green monkey kidney cells, and it is working on a vaccine for the United States.
But the Deerfield, Ill., company has not said yet whether it will build a U.S. factory, which the federal government required in the contracts. Britain's GlaxoSmithKline spent $300 million on a facility in Marietta, Pa., but it remains in the earliest stages of development.
Sanofi Pasteur shelved its efforts after studies indicated the cell-based vaccine it was developing was not superior to the traditional vaccine it makes at its new $200 million facility in Swiftwater, Pa. Solvay dropped out after deciding to expand its production capacity in The Netherlands instead of building a U.S. factory. MedImmune of Gaithersburg put its program on hold after the FDA demanded additional studies that the company argued were unnecessary.
Even if cell-based vaccines eventually make it to the U.S. market, no one sees them as a long-term solution. They may shave weeks off the production time, which this year would have made a significant difference. But they still require lengthy production schedules for purification and testing.
Latest Modern approaches
More promising is a new generation of vaccines that do not depend on growing the virus. Instead, they exploit the latest in genetic technologies to use the viral DNA to quickly churn out key proteins to elicit a protective immune response.
Protein Sciences of Meriden, Conn., has applied to the FDA for approval to sell a vaccine made by genetically engineering flu genes into a worm virus, which then infects cells from caterpillar ovaries to produce the necessary proteins to make vaccine.
"The other approaches are evolutionary. Ours is revolutionary," said Daniel D. Adams, the company's chief executive.
After being turned down for government funding for years, the company last spring won a five-year, $147 million contract from HHS to develop the vaccine. An FDA advisory panel Thursday voted that the vaccine appeared to be effective in adults but more studies were needed, including to make sure it worked in children and was safe.
Novavax of Rockville is testing a similar vaccine on 4,000 people in Mexico in the hopes of getting an H1N1 vaccine approved by Mexican regulators.
VaxInnate of Cranbury, N.J., for example, produced an experimental H1N1 vaccine using genetically engineered E.coli bacteria, and Vical of San Diego just won a $1.25 million contract from the Navy to develop an H1N1 vaccine that involves injecting DNA sequences from the virus directly into people.
But these remain probably years away from producing a marketable vaccine, and given the skittishness of many Americans about the traditional shots and even the newer nasal spray, it remains unclear how many would feel comfortable with vaccines produced using insect cells, bacteria, animal kidney cells or other new approaches.
"It will be a uphill road in convincing people that it's safe and effective and represents an advance," said Gregory Poland, a flu vaccine expert at the Mayo Clinic.
Many experts say that while these approaches potentially offer a much quicker and easier way to produce large amounts of vaccine, they do not represent the ultimate solution.
That goal, they say, would be to produce a "universal vaccine," which would not have to be altered each year to match whatever strain of the virus is circulating.
"That would be the home run of flu vaccines," said John Treanor, a University of Rochester flu vaccine expert.
Other experts said the federal government should also take steps to guarantee vaccine makers that it would buy any excess vaccine and subsidize excess vaccine production capacity.
"Imagine if this was 1918-like influenza and lots more people were dying and we had no vaccine. We would see the world coming to a screeching halt," said Michael T. Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "This should be a wake-up call that we need to have an intervention that allows us to stay in control. Right now the virus is in charge."
This April 16, 2009 file photo, shows a sign at the Citigroup Center in New York. Some of New York City's largest employers - including Citigroup - have started receiving doses of the much-in-demand swine flu vaccine for their at-risk employees. The swine flu vaccine has been in short supply nationwide because of manufacturing delays, resulting in long lines at clinics and patients being turned away at doctor's offices. The government has recommended that the limited supply go first to high-risk groups: children and young people through age 24, people caring for infants under 6 months, pregnant women and health care workers. Citigroup has received 1,200 doses, health officials said.
UPDATES with most recent information; graphic shows the weekly number of swine flu vaccine shipments since Oct. 14; includes state-by-state breakdown for most recent week
Some of New York's biggest companies, including Wall Street giants Goldman Sachs and Citigroup, received doses of swine flu vaccine for at-risk employees, drawing criticism that the hard-to-find vaccine is going first to the privileged.
Hospitals, universities and the Federal Reserve Bank also got doses of the vaccine for employees who need it the most, such as pregnant women or chronically ill workers, according to the city's health department.
In order to receive the vaccine, companies had to have their own medical staff. Distributing large doses of the vaccine to such businesses is "a great avenue for vaccinating people at risk," said Jessica Scaperotti, spokeswoman for the city Department of Health and Mental Hygiene.
But critics said Wall Street firms should not have access to the vaccine before less wealthy Americans.
"Vaccines should go to people who need them most, not people who happen to work on Wall Street," Democratic Sen. Chris Dodd of Connecticut said Thursday.
"Wall Street banks have already taken so much from us. They've taken trillions of our tax dollars. They've taken away people's homes who are struggling to pay the bills," union official John VanDeventer wrote on the Web site of the 2 million-member Service Employees International Union. "But they should not be allowed to take away our health and well-being."
Meanwhile, the director of the federal Centers for Disease Control and Prevention sent a letter Thursday to state and local health departments asking them to review their distribution plans and make sure the vaccine is getting to high-risk groups.
Dr. Thomas Frieden said any decisions that appear to send vaccine beyond high-priority groups "have the potential to undermine the credibility of the program."
Swine flu vaccine has been in short supply nationwide because of manufacturing delays, resulting in long lines at clinics and patients being turned away at doctor's offices. The vaccine started trickling out in early October, and there are now nearly 36 million doses available.
The government-funded vaccine is being distributed to states, where health departments decide where to send the limited doses.
In New York, doctors at companies that have employee health services can request the vaccine along with other doctors but must agree to vaccinate only high-risk employees, Scaperotti said.
Last month, the city began offering vaccine to schoolchildren, as well as to pediatricians and obstetricians who asked for it. Scaperotti said two-thirds of the pediatricians in New York City have requested vaccine.
New Yorkers who cannot get the vaccine at work are receiving it from their doctors — if their doctors have it — or at community health clinics.
About 50 people waited to be vaccinated Thursday at a city-run clinic in Manhattan's Chelsea neighborhood. Matt Bohart said he and his 82-year-old father, Eugene Bohart, had been waiting for three hours for both swine flu and seasonal flu vaccines.
The younger Bohart said the fact that employees of some companies can get the vaccine at work seemed "not really fair."
But he added, "I don't begrudge the people who get it as long as others can get it as well."
Dr. William Schaffner, a flu expert at Vanderbilt University, said allocation of limited vaccine is tricky. CDC guidelines provide a list of patients who should be at the front of the line: children and young people through age 24, people caring for infants under 6 months, pregnant women, health care workers, and adults with health conditions such as asthma and diabetes.
Schaffner said that if corporations are giving shots to at-risk people, the distribution may have been appropriate. But he acknowledged there's "an appearance of potential irregularity."
Still, he said, "I have a feeling that if it were a Ford dealership that got vaccine, there wouldn't be quite as much excitement."
Scaperotti said 50 employers in New York City have received the vaccine so far. Besides Goldman Sachs and Citigroup, they include Time Inc. and hospitals such as Memorial Sloan-Kettering Cancer Center.
Goldman Sachs has received 200 doses, and Citigroup has received 1,200, health officials said.
In statements, Citigroup and Goldman Sachs said the vaccine would only go to those in high-risk groups.
"Goldman Sachs, like other responsible employers, has requested vaccine and will supply it only to employees who qualify," spokesman Ed Canaday said.
Morgan Stanley received 1,000 doses of the vaccine for its New York and suburban offices, but the company turned over its entire supply to local hospitals when it learned it received shipments before some area hospitals, spokeswoman Jeanmarie McFadden said.
The White House circled the wagons just hours after reports that Wall Street giants Goldman Sachs and Citigroup got vaccine for their high-risk workers while some hospitals and clinics are still waiting for it.
White House officials defended their handling of the H1N1 outbreak after an uproar over local officials' mistakes and what appeared to be their own misleading comments.
"The president has done everything humanly possible to get ready for this epidemic," White House spokesman Robert Gibbs said Thursday.
Gibbs' comments came just hours after reports that Wall Street giants Goldman Sachs and Citigroup got vaccines for their high-risk workers while some hospitals and clinics are still waiting for it.
"If you're going to prioritize everybody who works in a contained area, maybe you ought to be at elementary schools instead of Wall Street banks," said Rep. Roy Blunt, R-Mo.
The Service Employees International Union was more harsh in its criticism.
"It's bad enough that Wall Street crashed our economy. But purposely endangering the health of millions of Americans during a public health crisis crosses all lines of decency," the union said in a statement.
Gibbs blamed local officials that he said have already been scolded by the Centers for Disease Control.
"The CDC director is sending a letter to every state and city receiving vaccine to reiterate that vaccine should be going to priority groups per the CDC," Gibbs said.
But in recent days, Gibbs himself appeared to mislead when asked whether H1N1 vaccine would be given to detainees at Guantanamo Bay.
"There is no vaccine in Guantanamo and there's no vaccine on the way to Guantanamo," Gibbs said Tuesday.
A day later, a Pentagon spokesman made clear Gibbs should have said "yet" because vaccine will eventually be going to Gitmo based upon the need to protect our forces from the risk posed by an outbreak of swine flu within the confines of the detention facility.
Officials say vaccine will be provided to U.S. troops overseas before it's sent to Gitmo, but they won't say if that's before it's widely available to the general public in this country, which is probably sometime in December. The White House says pharmaceutical companies overestimated how fast they could create the vaccine but critics say Obama waited too long to declare an emergency, which speeded up the distribution process.
"The president could have done some things 10 weeks ago that he did 10 or so days ago to waive some liability concerns and some other things that get this vaccine available," Blunt said.
The White House is also fighting critics who say the swine flu missteps bode ill for the push for health care reform. Gibbs says the connection is strained and he rejects the claim that the vaccine shortages suggest health reform might not be well thought out.
Health and Human Services Secretary Kathleen Sebelius promised that, despite delays, there would eventually be enough swine flu vaccine for all Americans. “The vaccine is coming out the door as fast as it comes off the production line,” she said. The secretary appeared on three morning television news programs to deliver the assurance. Slow growth of the vaccine in eggs and different production problems at the five companies making the vaccine mean the country will have only about 30 million doses by the end of this month.
Ontario has become the first province to delay seasonal influenza vaccines to most residents because of the threat posed by swine flu.
The decision, announced Thursday, comes as public health officials across the country are reconsidering their immunization plans in light of unpublished Canadian studies that suggest earlier seasonal flu shots raise the risk of contracting the pandemic H1N1 flu virus.
“Is it typical that we adjust our programs?” said Arlene King, Ontario's chief medical officer of health. “No, it isn't typical, but we are not dealing with a typical flu season this year.”
Ontario's program is based on a calculation that swine flu will sicken more people than seasonal influenza this fall and winter. Despite hopes for a pan-Canadian vaccination strategy, the province's approach is different than those in other provinces.
Parents panicked over whether their sick children might have swine flu are unnecessarily clogging Houston's emergency rooms, and supplies of the most popular flu symptom-fighting drug aren't meeting the region's demand, health officials said Thursday.
Waiting rooms at both children's hospitals in the Texas Medical Center are packed at levels typically seen in January, the peak of traditional flu season, officials said. Texas Children's Hospital opened an outdoor assessment center under a tent Wednesday afternoon to handle a 40 percent increase in patients. Children's Memorial Hermann Hospital has had an equivalent increase in flu patients, spokeswoman Jennifer Hart said, and there's been a significant uptick at Memorial Hermann's community hospitals.
Clinicians say the scene is similar to what happened in the spring, when the H1N1, also known as swine flu, broke out in Mexico and was transmitted across the globe. Children and young adults are especially at risk, having the highest rates of hospitalization and deaths.
Meanwhile, federal health officials on Thursday said the first swine flu vaccinations should be available in the coming weeks, though there won't initially be enough for everyone to be treated.
“We are likely to have some initial doses available the first full week in October,” said U.S. Health and Human Services Secretary Kathleen Sebelius.
Sebelius said 6 million to 7 million doses will be available in that initial batch. Priority will be given to those considered most vulnerable, including children, pregnant women and health workers.
By mid-October, roughly 40 million doses will be distributed, officials said. And every week thereafter, 10 million to 20 million doses will roll out across America.
The federal government has purchased 250 million vaccines, “enough for everyone in America who wants a vaccine,” Sebelius said.
Health and Human Services Secretary Kathleen Sebelius said that the first round of swine flu vaccine could be ready by early October
The nation's first round of swine flu shots could begin sooner than expected, with some vaccine available as early as the first week of October, Health and Human Services Secretary Kathleen Sebelius said Sunday.
Sebelius said she is confident the vaccine will be available early enough to beat the peak of the expected flu season this fall and that early doses are intended for health care workers and other high-priority groups.
"We're on track to have an ample supply rolling by the middle of October. But we may have some early vaccine as early as the first full week in October. We'll get the vaccine out the door as fast as it rolls off the production line," she told ABC's "This Week."
The possibility of early shots follows encouraging news from last week about the swine flu vaccine. Researchers have discovered that one dose instead of two could be enough for healthy adults, and protection could begin once vaccinated within 10 days instead of three weeks.
"That's great, which means we'll have a lot more vaccine," she said. "We also have seen a robust immune response within 10 days, instead of three weeks as was feared."
Sebelius said the vaccine doses will be distributed immediately to designated locations across the country once they are available.
"Every state has a plan saying these are the sites to get the vaccine as quickly as possible into people's arms. That's where the distribution will go," she said.
"So, the first week in October, we expect some of the vaccine to begin to roll, and by mid-October, to have the kind of supplies we were talking about. But we may have some available earlier. And we'll get it out to states as fast as it comes off the production lines," Sebelius said.
One dose means tight supplies of H1N1 vaccine won't be stretched so badly. Had it taken twice that dose, or two shots apiece, half as many people could have received the vaccine.
The winter flu vaccine is widely available now, and health authorities urged people last week to get shots now before swine flu shots start arriving.
In addition to concerns about swine flu, doctors also expect some garden-variety flu this fall as well, an illness that typically kills 36,000 Americans and hospitalizes 200,000 each year.
The officials expect about 50 million doses of swine flu vaccine to reach government warehouses by Oct. 15, and 20 million more to be ready each week after that until 195 million is reached.
Then those lots must be shipped to health centers, schools and other vaccination sites, people must be injected, and each must develop immunity. Immune responses are different in each individual, but the clinical trials suggest that most will be protected after 8 to 10 days.
So if the epidemic’s peak comes in late October, millions of people are likely to catch the flu before the vaccine is available.
“A month would have made a huge difference,” said Ira M. Longini Jr., an author of a report by an epidemic-modeling team at the Fred Hutchinson Cancer Research Center in Seattle and the University of Washington.
If one shot turns out to be protective in children and if the flu peaks in late December, as the 1968 Hong Kong flu did, “we could be O.K.,” Dr. Longini said. “But that’s a lot of ifs.”
In response, federal officials said there was no way to tell whether the pessimistic models would be right, since flu peaks at different times in different regions each year.
Health and Human Services Secretary Kathleen Sebelius"We're on track to have an ample supply rolling by the middle of October. But we may have some early vaccine as early as the first full week in October. We'll get the vaccine out the door as fast as it rolls off the production line," she told ABC's "This Week."The city has offered every school kid a free swine flu vaccine when it becomes available.
The winter flu vaccine is widely available now, and health authorities urged people last week to get shots now before swine flu vaccines start arriving.
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Health Secretary Kathleen Sebelius on Sunday said the United States now expects to receive the first batch of swine flu vaccine in early October, a few weeks earlier than expected."The first week in October, we expect some of the vaccine to begin to roll," Sebelius said.On Friday, the health secretary said clinical trails had shown a single dose of the vaccine was enough to ensure immunity within 10 days.
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A White House panel is warning that the H1N1 flu virus could infect up to half of the American population in the coming months ad may lead to as many as 90,000 deaths
Antiviral medications such as Tamiflu and Relenza, which are effective in treating the H1N1 swine flu, should be taken only by people hospitalized with the flu or those at high risk for complications from the disease, U.S. health officials said Tuesday.
Those at risk include people with underlying health conditions, such as asthma or diabetes, as well as the very young, the elderly, and pregnant women, officials said.
Because the H1N1 swine flu remains mild for the vast majority of people who get it, most people won't need these medications at all, according to new guidelines for antiviral drug use issued by the U.S. Centers for Disease Control and Prevention.
"Antiviral medicines are a critical part of our tool kit in countering influenza, both the 2009 H1N1 influenza virus and seasonal flu strains," Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said during an afternoon news conference.
But, Schuchat added, "most children, adolescents and adults who have influenza-like illness do not need antiviral medicine."
One reason why: If too many people take antiviral medicines it could increase the risk that the virus would become resistant to these drugs, Schuchat said.
"We have seen a bit of antiviral resistance already with the 2009 H1N1 strain, and we hope this won't take off," she said. "A critical feature is to use these antivirals very carefully so they can have benefit and not lead to problems."
Because most people who get the flu -- whether H1N1 swine flu or seasonal flu -- will not be tested to see what type of flu they have, the new guidelines are based on symptoms, not a particular flu strain, Schuchat said.
"A key point of the antiviral guidance is that hospitalized patients who are suspected to have influenza need prompt treatment with antiviral medicines," she said. "That can be a very important way to reduce the severity of illness. We don't want providers to wait until test results are available, but we want them to start antivirals when you suspect influenza."
The new guidelines also recommend that, when high-risk people have been in contact with someone who has the H1N1 swine flu, doctors should wait to see if flu symptoms develop before starting treatment with antivirals.
She stressed, however, that the new guidelines leave room for judgment and discretion on the part of doctors. "Every patient is different, and we want clinicians to have that opportunity to customize care for each patient," she said.
The recommendations include:
* Treatment with antivirals is recommended for people at higher risk for complications. These include children younger than 5 years old, adults 65 and older, pregnant women, people with chronic medical or immunosuppressive conditions, such as patients on chemotherapy, and people younger than 19 years of age who are receiving long-term aspirin therapy. * Treatment should not wait for lab tests because testing can delay treatment and a negative rapid test for flu does not rule out influenza. * For some high-risk patients, doctors may choose to give them antiviral prescriptions that can be filled should symptoms appear. --------------
The first 45 million doses of the vaccine are expected by mid-October.
The World Health Organisation stuck on Tuesday to its statement that about two billion people could catch H1N1 influenza by the time the flu pandemic ends.
"By the end of a pandemic, anywhere between 15-45 percent of a population will have been infected by the new pandemic virus," WHO spokeswoman Aphaluck Bhatiasevi said in a statement.
The WHO's latest update on July 27 said a total of 816 people had died from H1N1, while the total number of laboratory-confirmed cases, including deaths, was 134,503 -- a figure well below the likely real total of infections which may already be in the millions, according to health experts.
WHO spokeswoman Fadela Chaib said the agency hoped to give an update on its vaccine plans later this week. Leading flu vaccine makers include Sanofi-Aventis (SASY.PA), Novartis (NOVN.VX), Baxter (BAX.N), GlaxoSmithKline (GSK.L) and Solvay (SOLB.BR).
- 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.
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-This podcast discusses the use of antiviral drugs for treating and preventing the H1N1 flu virus.
