China: H1N1 Becoming Dominant Flu Virus

 

 

# 3922

 

A translation today of a Chinese language article appearing on Xinhuanet, where the Health Minister of China, Chez Zhu, calls the epidemic situation there `grim’.

 

While no mutation of the virus has been detected, he warns that increased levels of `severe disease and deaths’ are inevitable.

 

It was only 2-weeks ago in the WHO Pandemic update # 70 that we were advised:  

Of note, nearly half of the influenza viruses detected in China are seasonal influenza A (H3N2) viruses, which appeared prior to and is co-circulating with pandemic H1N1 2009 virus. 

Today’s report indicates that:

Influenza A H1N1 positive samples accounted for the proportion of all influenza-positive specimens has reached more than 70%.

Which would suggest that the pandemic H1N1 virus is rapidly crowding out other seasonal contenders. Whether that will continue to be the case later in the year, or in subsequent flu seasons, is unknown.  

A hat tip to Florida1 on Flutrackers for finding, translating, and posting this article.

 

 

Minister of Health Chen Zhu: Influenza A H1N1 flu cases has increased in severe and death is inevitable

Xinhua Beijing October 31 (Xinhua Zhou Ting-yu)

 

"At present, although not Influenza A H1N1 influenza virus mutates, the majority of patients with mild disease, but the increasing cases of severe and death is an inevitable trend." Minister of Health Chen Zhu has do a good job in the overall prevention of influenza A H1N1 influenza vaccine immunization work, said the mobilization of the General Assembly.

 

Informed the Ministry of Health, as of October 30, China's mainland had reported 44,981 cases of Influenza A H1N1 influenza confirmed cases, 33,184 cases had been cured.Total 82 cases of cases of severe disease has been cured in 29 cases, 6 died.

 

Chen Zhu said that in the October, the nation's ever-increasing cases of severe disease, the epidemic situation is quite grim.

 

According to the National Influenza Surveillance Network, monitoring data, Influenza A H1N1 positive samples accounted for the proportion of all influenza-positive specimens has reached more than 70%.

 

This suggests that influenza A H1N1 influenza virus in China has been widely taken root and become the dominant virus, influenza virus.

 

World Health Organization believes that the current global real number of cases and deaths are higher than the reported number of influenza A H1N1 influenza virus transmission power significantly higher than other seasonal influenza, the epidemic continued to show a rapid upward trend.

 

"Vaccination with the Influenza A H1N1 influenza vaccine is to do specific prevention and control work, and the most effective means of." Chen Zhu stressed that the influenza A H1N1 influenza vaccines do work, for the maintenance of our public service system functioning, reducing specific population outbreaks from occurring, reduce morbidity and mortality, reduce the hazard of an influenza pandemic in order to effectively prevent and control the second wave of the epidemic of great significance.

 

Local health departments with the joint prevention and control mechanisms for close cooperation between relevant, clear responsibilities, implementing the responsibility to ensure that H1N1 influenza vaccine immunization work successfully completed.

Ukraine: A Rush To Buy Flu Supplies

 

 

# 3921

 

 

 

While the true scope of the flu outbreak in the Ukraine is anything but clear, the news coverage of the past few days has been sufficient to drive many people to local pharmacies to stock up on masks and other flu supplies.

Consequently, pharmacies have reportedly raised prices, and some shelves are now empty.

 

This report from http://www.javno.com

 

Ukrainians empty pharmacies in swine flu panic

• In Lviv in the western region, some pharmacies ran out of flu medicines and masks on Saturday after worried customers made bulk purchases.

 

Ukraine residents emptied pharmacies of masks and flu medicines on Saturday after the government ordered a three-week closure of schools and cinemas to combat swine flu.

 

In Lviv in the western region, some pharmacies ran out of flu medicines and masks on Saturday after worried customers made bulk purchases.

 

Residents complained pharmacies were profiting from the panic.

 

"Look at the lines there, how much medicine they've sold and how much they've put prices," said pensioner Maria Teodorovich. "People are buying up everything they see."

 

In Kiev, residents said flu medicines were hard to find.

 

"I've been to so many pharmacies and can't find medicines anywhere. And flu is on its way," said pensioner Yelena Mikhailova, covering her face with a paper tissue.

 

 

(Continue)

 

As of this writing, there are reports of as many as 48 deaths attributed to this `pneumonia’, and as many as 150,000 influenza cases. 

 

Admittedly not a huge number of deaths given the number of cases, but deaths are generally under-counted and are often a `trailing indicator’ in an outbreak.  Additionally, there have been media reports of a few cases involving a `hemorrhagic pneumonia’, which has also raised concerns.

 

Whether this outbreak constitutes anything out of the ordinary is impossible to tell at this juncture, but it has aroused enough interest that the WHO's Global Outbreak Alert and Response Network (GOARN) team will travel to the Ukraine next week. 

  

You’ll find earlier coverage of these events in:

WHO Dispatching Team To Ukraine

Ukraine Update: H1N1 Quarantine

Reports Out Of The Ukraine

Referral: Effect Measure On Statins

 

 

# 3920

 

Revere over at Effect Measure has a terrific piece today about the frustrating lack of research on statins, which are suspected by some researchers to harbor promise as treatment for influenza.

 

I’d have recommended this blog, even if there wasn’t a very kind hat tip to AFD in it (thanks guys!). 

 

I’ll just step aside and send you to:

 

Statins for influenza. Why don't we know if it works yet?

Category: Infectious disease • Influenza treatment

Statins for influenza are in the news again, this time because of a paper given at the Annual Meeting of the Infectious Disease Society of America (IDSA). We'll get to it in a moment, but first a little background.

Read on »

 

 

As a reminder, Dr. David Fedson will be interviewed on Radio Sandy Springs by Sharon Sanders of FluTrackers this coming Monday, at 4pm (EST).    No doubt, statins will be part of the discussion.

The International House Of Pandemics

 

# 3919

 

 

A couple of quick graphics that I thought might be of interest to my readers.

In recent days nearly half of those reading this blog are logging in from outside of the United States.  Since I’ve tried to make this blog international in scope, this is a very gratifying thing indeed.

 

(Click image to Enlarge)

 

 

Since April of this year, I’ve had visitors from more than 150 countries and territories around the globe. On a routine basis, I see visits each month from more than 70 countries.

 

My visitor map for the past 6 months.   (Click image to enlarge.)

 

I am humbled beyond words by the gracious reception this blog has received over the years.  When I started back in early 2006, I never expected anyone but family and a few friends would read it. 

This has been a very happy, though completely unexpected, surprise.

 

Thank you.

Canada’s Vaccine Shortfall

 

# 3918

 

As the United States struggles with its slower than anticipated roll out of the pandemic vaccine, so do officials in Canada, where news of additional delays became public yesterday.

 

Crof at Crofsblog has done a terrific job following this story over the past couple of days, with entries such as Must-read of the day  and Canada: BC downplaying H1N1 vaccine shortage.

 

As I pointed out in Murphy's Laws And Vaccine Production last July, and in A Vaccine Reality Check back in May, there are a lot of things that can go wrong during vaccine manufacturing.

 

 

From Healthzone.ca  we get details on the announced shortfall of vaccine in Canada due to production problems at the GSK plant in Ste-Foy, Quebec.

 

 

Vaccine glitch delays H1N1 flu shots

October 31, 2009

Theresa Boyle

Joanna Smith

What has been touted as the largest vaccination campaign in Canada's history hit a major hurdle Friday when health officials announced a production glitch had resulted in a significant shortfall in vaccine supply.

 

Instead of beginning mass immunizations next week, Ontario public health units are being forced to ration limited inventories, delaying plans to vaccinate healthy people so that those at risk of complications from the H1N1 virus and health-care workers can get their shots first.

 

And beginning Saturday, as the number of clinics in Toronto increases to four, Toronto public health officials will beef up screening efforts and turn away from clinics anyone deemed not high priority for the flu shot.

 

While healthy individuals had been invited to start getting their shots at some clinics starting Monday, it's now uncertain when there will be enough vaccine for them.

 

"We have added staff who will be walking along the line and screening to ensure that the people that will get the vaccine will only be in the priority groups," warned Toronto's associate medical officer of health, Dr. Barbara Yaffe.

 

The head of the Public Health Agency of Canada, Dr. David Butler-Jones, said Friday only about 625,000 doses of the H1N1 vaccine are expected to reach flu clinics across the country in next week, compared to the 2 million doses that have been shipped in each of the past three weeks.

 

Ontario, which had been expecting to receive 1 million doses of vaccine next week, will instead receive only 170,000 doses of the regular version of the vaccine that contains an adjuvant – a chemical additive that stretches supply and boosts immunity – and 86,800 doses of the adjuvant-free version for pregnant women.

 

(Continue . . . )

WHO Dispatching Team To Ukraine

 

# 3917

 

Note: This story is updated 10/31/09 at

Ukraine: A Rush To Buy Flu Supplies

 

Given the number of press reports of flu-related illnesses and deaths coming out of the Ukraine in the past 72 hours, it is not terribly surprising that the World Health Organization has been asked to send a team in to investigate.

 

You’ll find earlier reports on the Ukrainian situation at:

Ukraine Update: H1N1 Quarantine

Reports Out Of The Ukraine

 

 

This report from The Canadian Press.   A Hat tip to RWilmer on FluTrackers for posting this story.

 

 

 

WHO says it's sending team to Ukraine to probe reports of serious H1N1 activity

 

(CP)

GENEVA — The World Health Organization is sending a team of experts to Ukraine to look into reports of severe H1N1 disease there, a spokesperson for the global health agency said Friday.

 

Gregory Hartl said the team was being pulled together by the WHO's Global Outbreak Alert and Response Network, which goes by the acronym GOARN.

 

The team will travel early next week to the eastern European country, which has closed schools and banned public meetings in response to a spike in cases of acute respiratory illness believed to be H1N1.

 

(Continue . . . )

FluView Week 42

 

# 3916

 

 

The CDC has posted FluView for week 42, ending October 24th, 2009. The level of activity we are seeing is roughly what we might expect during the height of the flu season, not during  mid-to-late October.

 

I’ve excerpted some of the data and graphs below, but follow the link to read it in its entirety.

 

Synopsis:

During week 42 (October 18-24, 2009), influenza activity increased in the U.S.

• 8,268 (42.1%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
• All subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
• The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold.
• Twenty-two influenza-associated pediatric deaths were reported. Nineteen of these deaths were associated with 2009 influenza A (H1N1) virus infection and three were associated with an influenza A virus for which the subtype was undetermined.
• The proportion of outpatient visits for influenza-like illness (ILI) was above the national baseline. All 10 regions reported ILI above region-specific baseline levels.
• Forty-eight states reported geographically widespread influenza activity, Guam and two states reported regional influenza activity, the District of Columbia and Puerto Rico reported local influenza activity, and the U.S. Virgin Islands did not report.

 

U.S. Virologic Surveillance:

WHO and NREVSS collaborating laboratories located in all 50 states and Washington D.C., report to CDC the number of respiratory specimens tested for influenza and the number positive by influenza type and subtype. The results of tests performed during the current week are summarized in the table below.

 

 

Pneumonia and Influenza (P&I) Mortality Surveillance

During week 42, 7.1% of all deaths reported through the 122-Cities Mortality Reporting System were due to P&I. This percentage was above the epidemic threshold of 6.6% for week 42. Including week 42, P&I mortality has been above threshold for four consecutive weeks.

 

 

Influenza-Associated Pediatric Mortality

Twenty-two influenza-associated pediatric deaths were reported to CDC during week 42 (Arizona [3], Florida, Georgia, Guam, Montana, Ohio, South Dakota, Tennessee [2], Texas [9], Washington, and Wisconsin). Nineteen of these deaths were associated with 2009 influenza A (H1N1) virus infection and three were associated with an influenza A virus for which the subtype is undetermined.

 

These deaths occurred between August 23 and October 24, 2009. One death reported during week 42 occurred during the 2008-09 season. Since August 30, 2009, CDC has received 74 reports of influenza-associated pediatric deaths that occurred during the current influenza season (nine deaths in children less than 2 years old, nine deaths in children 2-4 years old, 27 deaths in children 5-11 years old, and 29 deaths in individuals 12-17 years old).

 

Sixty-five of the 74 deaths were due to 2009 influenza A (H1N1) virus infections, and the remaining nine were associated with influenza A virus for which the subtype is undetermined. A total of 114 deaths in children associated with 2009 H1N1 virus have been reported to CDC.

SAGE Advice

 

# 3915

 

 

SAGE, the Strategic Advisory Group of Experts on Immunizations, advises the WHO (World Health Organization) on policies and strategies for vaccination around the world.  

 

Earlier today, the WHO released a vaccination Briefing note based on SAGE’s latest recommendations.  (see WHO Briefing Note # 14: Vaccine Policies And Strategies)

 

Helen Branswell, ace medical reporter for The Canadian Press, untangles some of the complexities of this SAGE advice, including a reversal of an earlier recommendation that unadjuvanted vaccines be provided to pregnant women whenever possible.

 

As always with a Branswell report, it’s worth taking the time to read the whole thing.

 

 

Single H1N1 shot sufficient, pregnant women can use adjuvanted vaccine: WHO

 

By Helen Branswell Medical Reporter (CP) 

A single dose of H1N1 vaccine should be adequate for all age groups, even very young children, and pregnant women should feel free to use vaccine containing adjuvant, an expert committee that advises the World Health Organization on vaccine issues reported Friday.

 

The group, known by the acronym SAGE, said vaccines containing boosting additives called adjuvants and vaccines that are adjuvant-free appear to be equally safe and there is no need to recommend pregnant women get the latter on a preferential basis.

 

"This is based on the fact that the safety profiles of adjuvanted vaccine and the non-adjuvanted vaccine are very similar, and the fact that the non-adjuvanted vaccine has been recommended for pregnant women for many, many years," Dr. Marie-Paule Kieny, director of the WHO's initiative for vaccine research, said in reporting on the recommendations of the panel.

 

"So there is no reason, in SAGE's view, to distinguish between both types of vaccines."

 

(Continue . . . )

CDC’s Weekly Flu Indicators

 

# 3914

 

Just posted (1:30pm EDT) on the CDC.gov/h1n1flu  website is this week’s flu situation update.    Later today we’ll get a more detailed FluView report.  This data is for the week of October 18-24th.

 

As I reported yesterday, 22 pediatric influenza deaths were added last week, 19 laboratory confirmed as being H1N1.

 

 

 

2009 H1N1 Flu: Situation Update

October 30, 2009, 1:30 PM ET

U.S. Situation Update

Weekly Flu Activity Estimates

U.S. Patient Visits Reported for Influenza-like Illness (ILI)

U.S. Influenza-like Illness (ILI) Reported by Regions

U.S. Influenza and Pneumonia-Associated Hospitalizations and Deaths from August 30 to October 24, 2009

International
Situation Update

Map of International
Activity Estimates
(Including 2009 H1N1 Flu)

Key Flu Indicators

October 30, 2009, 1:30 PM

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of October 18-24, 2009, a review of the key indictors found that influenza activity continued to increase in the United States from the previous week. Below is a summary of the most recent key indicators:

• Visits to doctors for influenza-like illness (ILI) increased steeply since last week in the United States, and overall, are much higher than what is expected for this time of the year. ILI activity now is higher than what is seen during the peak of many regular flu seasons.
• Total influenza hospitalization rates for laboratory-confirmed flu are climbing and are higher than expected for this time of year. Hospitalization rates continue to be highest is younger populations with the highest hospitalization rate reported in children 0-4 years old.
• The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and has been higher than what is expected at this time of year for four weeks now. In addition, 22 flu-related pediatric deaths were reported this week; 19 of these deaths were confirmed 2009 H1N1, and three were influenza A viruses, but were not subtyped. Since April 2009, CDC has received reports of 114 laboratory-confirmed pediatric 2009 H1N1 deaths and another 12 pediatric deaths that were laboratory confirmed as influenza, but where the flu virus subtype was not determined.
• Forty-eight states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. This many reports of widespread activity are unprecedented during seasonal flu.
• Almost all of the influenza viruses identified so far are 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

IDSA: Kids Shed Virus Longer Than Adults

 

# 3913

 

 

More evidence, presented at the IDSA (the Infectious Diseases Society of America) in Philadelphia this week, indicating that children shed the influenza virus longer than adults.  

 

This isn’t the first time we’ve heard this sort of data (see Swine Flu: The Gift That Keeps On Giving).

 

The guidance from the CDC for staying home, and not going to work or school, has been scaled back from at least 7 days or 24 hours after symptoms disappear – to 24 hours after fever is gone (without using fever reducing drugs).  

 

Which means that some people may be returning to work or school following an illness while still shedding the virus.

 

Whether this really makes much of a difference is debatable. 

 

Shedding enough virus to be detectable by today’s modern RT-PCR testing or culture, and being contagious and able to spread the virus, may be two entirely different propositions.  

 

It it is believed that people can shed the flu virus for to 24 hours before ever showing symptoms – and that some may carry the virus asymptomatically, and spread the virus to others - without ever falling ill themselves (see They Walk Among Us ).

 

All of which makes it virtually impossible to keep the virus out of the schools and workplace.  Since you can’t tell who is shedding the virus and who isn’t, the only real defense is to get vaccinated, and to practice good flu hygiene. 

 

This report from Medpage Today.

 

 

IDSA: Kids Shed H1N1 Flu Longer than Adults

By Michael Smith, North American Correspondent, MedPage Today
Published: October 30, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.

 

PHILADELPHIA -- Children appear to shed particles of the H1N1 pandemic flu virus longer than adults do, which may have implications for how long they stay out of school, a researcher said here.

 

The finding comes from an analysis of an outbreak in a Pennsylvania elementary school in May and June, according to Achuyt Bhattarai, MD, of the CDC.

 

Analysis of a series of specimens from affected children and their household contacts also showed that younger children tended to shed the virus longer than older kids, Bhattarai told attendees at the annual meeting of the Infectious Diseases Society of America.

(Continue . . .)

Ukraine Update: H1N1 Quarantine

 

 

# 3912

 

This story is updated  at

WHO Dispatching Team To Ukraine

 

 

Yesterday I reported on an outbreak of an `unknown disease’ that had claimed at least 22 lives (see Reports Out Of The Ukraine).   While test results were pending, it appeared that this outbreak was most probably due to the pandemic H1N1 virus.

 

Today, Ukrainian officials have confirmed that it has been identified as the H1N1 pandemic virus, and have announced extraordinary measures including partial quarantines, school closures, and travel restrictions will be utilized to try to slow the spread of the flu.

 

The newshounds at FluTrackers have been all over this story for several days, with now over 150 posts on their Ukraine: at least 30 die of swine flu - most were "young and healthy  and Ukraine - H1N1 - 37 fatalities suspected - 11 confirmed threads.

 

Hogweed brings us this report from KyivPost, the Ukraine’s largest English Language newspaper.   Their server is heavily burdened today, and load times can be delayed.

 

 

Ukrainian government imposes quarantine in nine western regions

Quarantine ordered

Today at 14:06

Ukraine suffered its first death from swine flu, as the government declared a massive quarantine and control effort to head off a possible epidemic, the Interfax news agency reported. The victim was a man living in Ukraine's western Lviv region, said Health Ministry spokesman Roman Pavliv.

 

The government announcement one week after reports surfaced of as many as 30 deaths potentially caused by swine flu, all in Ukraine's western provinces.

 

The Health Minister currently was monitoring 22 persons in the region showing swine flu symptoms, of which one had been confirmed as suffering from full-blown swine flu, according to the report.

 

"Unfortunately, we can state that there is in fact a swine flu epidemic in the country," said Vasyl Kniazhevych, Ukraine's Health Minister, at a Kyiv press conference. "We have a lot of work to do."

 

Ukrainian Prime Minister Yulia Tymoshenko ordered a massive and for Ukraine unprecedented disease-control program to go into effect immediately in an attempt to prevent the spread of the disease.

 

Schools nationwide will close for three weeks, and "all mass gatherings will be forbidden," Tymoshenko said, in comments reported by Channel 5 television.

 

The bans would come at the height of Ukraine's football season and autumn school semester. They would hinder much political campaigning planned by candidates in the January presidential elections.

 

A "full quarantine" will be imposed in nine of Ukraine's western provinces, with police monitoring the entrance and exit of all persons, she said. It will block those lacking justification for travel.

 

Read the remainder of the story here.

 

Other reports include this one from Reuters, posted by Dutchy.

 

Ukraine shuts schools,cancels public events due H1N1

Fri Oct 30, 2009

(Adds schools closed, public events banned)

KIEV, Oct 30 (Reuters) - Ukraine on Friday closed schools, banned all public events and imposed restrictions on people's movements around the country for a three-week period after confirming its first death from H1N1 swine flu.

"All educational institutions without exception ... will be switched on to a three-week holiday period," Prime Minister Yulia Tymoshenko announced. She indicated this period could be extended if it was deemed necessary.

 

"Apart from this, we will take the decision to cancel all mass meetings ... for three weeks," she said at an emergency government session.

 

"We will introduce a special system to stop unnecessary travel by people from one region to another," she added.

(Continue. . . )

 

While I’ll keep a watch on this evolving story, and bring you the highlights, the best place I know of to follow the hour-by-hour developments are on these FluTrackers threads.

Statins Revisited

 

 

# 3911

 

 

The question as to whether statins – commonly used cholesterol lowering drugs – might play a positive role in the treatment of influenza and pneumonia is one that we’ve discussed numerous times over the years.  

 

We’ve seen a see-sawing of opinion, driven by a parade of conflicting studies.  Today we’ve new research to look at, but first a review of the recent past.

 

Dr. David Fedson was probably the first to champion the idea of using statins for an influenza pandemic. In his paper on the subject, published in July of 2006.

 

Pandemic Influenza: A Potential Role for Statins in Treatment and Prophylaxis

David S. Fedson^a

The next influenza pandemic may be imminent. Because antiviral agents and vaccines will be unavailable to people in most countries, we need to determine whether other agents could offer clinical benefits. Influenza is associated with an increase in acute cardiovascular diseases, and influenza viruses induce proinflammatory cytokines.

 

Statins are cardioprotective and have anti-inflammatory and immunomodulatory effects, and they thus might benefit patients with influenza.

 

 

In 2007 we saw a study that seemed to support the idea, that indicated that statins lowered the mortality rate of people with pneumonia.

 

Statin drugs lower respiratory death risk: study

Tue Apr 10, 2007 12:40pm EDT

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - People who use statin drugs are less likely to die of influenza and chronic bronchitis, according to a study that shows yet another unexpected benefit of the cholesterol-lowering medications.

 

Their study of more than 76,000 people showed that those who had taken statins for at least 90 days had a much lower risk of dying from chronic obstructive pulmonary disease or COPD, the technical name for emphysema and chronic bronchitis.

 

Dr Fedson and Peter Dunnill, DSc,FREng  then collaborated on a commentary, published in the Permanente Journal, Summer 2007 edition, on how we might confront an imminent pandemic.

 

The commentary was called New Approaches to Confronting an Imminent Influenza Pandemic, and in it the authors presented options including two possible routes to producing vaccine in quantity, and the use of statins  to mitigate the effects of a cytokine storm.

 

(More on Dr. Fedson at the bottom of this blog)

 

In January of 2008, Australian researchers announced encouraging results from studies conducted on mice given gemfibrozil, a fibrate, which is another class of cholesterol lowering drug.

 

And just a year ago, in October of 2008, we learned:

 

Statins may cut pneumonia death, blood clot risks

27 Oct 2008 20:00:13 GMT

Source: Reuters

By Will Dunham

WASHINGTON, Oct 27 (Reuters) - Cholesterol-fighting drugs known as statins reduced the risk of dying from pneumonia or developing dangerous blood clots in the legs, adding to a growing list of benefits from the popular drugs, two research groups said on Monday.

 

Statins, the world's top-selling drugs, cut heart attack and stroke risk, and research has suggested other benefits including possibly protecting against Alzheimer's disease.

 

 

Of course, not all of the news was positive.  

 

Just last July we heard that there were no signs of benefit among pneumonia patients (see  Another Take On Statins And Pneumonia), where I reported on this story:

 

Statins don't lower risk of pneumonia in elderly

British Medical Journal study includes 3,000 Group Health patients

SEATTLE— Taking popular cholesterol-lowering statin drugs, such as Lipitor® (atorvastatin), does not lower the risk of pneumonia. That's the new finding from a study of more than 3,000 Group Health patients published online on June 16 in advance of the British Medical Journal's June 20 print issue.

 

"Prior research based on automated claims data had raised some hope—and maybe some hype—for statins as a way to prevent and treat infections including pneumonia," said Sascha Dublin, MD, PhD, a physician at Group Health and assistant investigator at Group Health Center for Health Studies. "But when we used medical records to get more detailed information about patients, our findings didn't support that approach."

 

Conflicting medical studies are nothing new.  We see them all the time.  Science is often messy and we get to the truth by fits and starts – and that can sometimes take years.  

 

Today we’ve news of new research on statins, presented at the annual meeting of the IDSA, the Infectious Diseases Society of America, in Philadelphia.  

 

Maryn McKenna writing for CIDRAP brings us the details.

 

Statins may help patients with severe seasonal flu

Maryn McKenna Contributing Writer

Oct 29, 2009 (CIDRAP News) – Commonly available drugs that are sold in lower-cost generic versions improve the survival of patients hospitalized for seasonal influenza, researchers reported today, raising the possibility of a widely available treatment that could be used in a severe flu pandemic if other drugs are in short supply.

 

The research, by the US Centers for Disease Control and Prevention (CDC) and scientists in several states, is part of a slate of new flu reports being presented this weekend at the annual meeting of the Infectious Diseases Society of America (IDSA) in Philadelphia. Also on the agenda: findings that flu vaccination of pregnant women has a protective effect on their babies both before and after birth, and news of what may be the first person-to-person transmission in the United States of H1N1 flu strains resistant to antiviral drugs.

 

The research presented Thursday examined the effect of the cholesterol-lowering drugs called statins on the clinical course of people who were already taking the drugs and then were hospitalized with lab-confirmed flu infections in the 2007-08 flu season. Those who were already on statins were half as likely to die, Meredith Vandermeer of the Oregon Public Health Division said during a press briefing at the state of the meeting.

 

The patients were identified via surveillance in 10 states conducted by the CDC’s Emerging Infections Programs; data on their lab results, prescriptions and outcome were drawn from reviews of their medical records. There were 2,800 lab-confirmed cases of flu in the surveillance results, Vandermeer said; 801 of those patients were recorded as taking statins during their hospital stay, presumably because they had been prescribed them before admission. Among the 2,800, 17 people who were on statins died, versus 64 were not on statins. Proportionally, that is 2.1% of those on statins and 3.2% of those not taking the drugs—a risk reduction of approximately half, Vandermeer said.

 

(Continue . . .)

 

Maryn’s article has additional details, plus reports on vaccine benefits in pregnant women, and the transmission of resistant H1N1 at a summer camp.   Follow the link to read it in it’s entirety.

 

While not conclusive, this latest study offers some additional tantalizing evidence that statins might someday play a role in the treatment of influenza and pneumonia.  

 

Further studies and controlled trials are needed, of course, before we can know for sure.

 

      *       *       *      *      *      *      *      *      *      *      *

 

Dr. David Fedson, will be interviewed again on Radio Sandy Springs by Sharon Sanders of Flutrackers, at 4pm on Monday, Nov 2nd.  You can listen online, or download the archived show later in the week.

 

Sharon interviewed Dr. Fedson last may, and you can listen to that archived show at 05/18/09 Guest Dr. David Fedson.

WHO Pandemic Update # 72

 

# 3910

 

It’s Friday, and so we get the weekly WHO (World Health Organization) update, along with the weekly FluView report from the CDC later in the day.

As always, the caveat that most nations are not testing for the H1N1 virus, nor are they tracking and reporting fatalities.  The numbers provided by the WHO represent a serious undercount of the true impact of the pandemic.

 

I’ve reparagraphed the summary for readability.  Follow the links to find additional charts, graphs, and information.

 

 

Pandemic (H1N1) 2009 - update 72

Weekly update

As of 25 October 2009, worldwide there have been more than 440,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and over 5700 deaths reported to WHO.

 

As of 25 October 2009, worldwide there have been more than 440,000 laboratory confirmed cases of pandemic influenza H1N1 2009 and over 5700 deaths reported to WHO.

 

As many countries have stopped counting individual cases, particularly of milder illness, the case count is likely to be significantly lower than the actual number of cases that have occurred.

 

WHO is actively monitoring the progress of the pandemic through frequent consultations with the WHO Regional Offices and member states and through monitoring of multiple sources of data.

 

Situation update:

 

In the temperate zone of the northern hemisphere, influenza transmission continues to intensify marking an unusually early start to winter influenza season in some countries. In North America, the US, and parts of Western Canada continue to report high rates of influenza-like-illness (ILI) and numbers of pandemic H1N1 2009 virus detections; Mexico has reported more confirmed cases since September than during the springtime epidemic.

 

In Western Europe, high rates of ILI and proportions of respiratory specimens testing positive for pandemic H1N1 2009 have been observed in at least five countries: Iceland, Ireland, the UK (N. Ireland), Belgium, and the Netherlands. Many other countries in Europe and Western and Central Asia are showing evidence of early influenza transmission, including in Spain, Austria, parts of Northern Europe, Russia, and Turkey.

 

In Japan, influenza activity has also increased sharply, especially on the northern island, approximately 10 weeks ahead the usual start of the winter influenza season.

 

Pandemic influenza transmission remains active in many parts of the tropical zone of the Americas, most notably in several Caribbean countries.

 

Overall transmission continues to decline in most but not all parts of the tropical zone of South and Southeast Asia.

 

Little influenza activity has been reported in temperate region of the southern hemisphere since the last update.

(Continue. . .)

WHO Briefing Note # 14: Vaccine Policies And Strategies

 

 

# 3909

 

 

The WHO (World Health Organization) announced this week that they would be making 200 million doses of donated vaccine available to 100 developing nations over the coming months.  

 

Today, in their 14th Pandemic Briefing note, they provide expert guidance on the use of vaccine.

You can find all 14 briefing notes HERE.

 

 

 

 

Experts advise WHO on pandemic vaccine policies and strategies

Pandemic (H1N1) 2009 briefing note 14

30 OCTOBER 2009 | GENEVA -- The Strategic Advisory Group of Experts (SAGE) on Immunization, which advises WHO on policies and strategies for vaccines and immunization, devoted a session of its 27–29 October meeting to pandemic influenza vaccines. The experts reviewed the current epidemiological situation of the pandemic worldwide and considered issues and options from a public health perspective.

 

Items on the agenda included the status of vaccine availability, results from clinical trials on vaccine immunogenicity, and early results from safety monitoring in countries where administration of the H1N1 pandemic vaccine is currently under way.

 

The experts also advised WHO on the number of doses of vaccine needed to confer protection, also in different age groups, the co-administration of seasonal and pandemic vaccines, and vaccines for use in pregnant women. Recommendations on the formulation of seasonal influenza vaccines for the southern hemisphere in 2010 were also provided.

 

Current situation

 

Globally, teenagers and young adults continue to account for the majority of cases, with rates of hospitalization highest in very young children. Between 1% to 10% of patients with clinical illness require hospitalization. Of hospitalized patients, from 10% to 25% require admission to an intensive care unit, and from 2% to 9% have a fatal outcome.

 

Overall, from 7% to 10% of all hospitalized patients are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely to need care in an intensive care unit when compared with the general population.

 

Based on these and other current findings, the experts made a number of recommendations.

 

Single dose recommended

 

The experts noted that a variety of pandemic vaccines, including live attenuated and both adjuvanted and non-adjuvanted inactivated vaccines, have now been licensed for use by regulatory authorities. SAGE recommended the use of a single dose of vaccine in adults and adolescents, beginning at the age of 10 years, provided such use is consistent with indications from regulatory authorities.

 

Data on immunogenicity in children older than 6 months and younger than 10 years are limited and more studies are needed. Where national authorities have made children a priority for early vaccination, SAGE recommended that priority be given to the administration of one dose of vaccine to as many children as possible. SAGE further stressed the need for studies to determine dosage regimens effective in immunocompromised persons.

 

Co-administration of vaccines

 

Clinical trials investigating the co-administration of seasonal and pandemic vaccines are ongoing, but SAGE acknowledged the recommendation, from the US Centers for Disease Control and Prevention, that live attenuated seasonal and live attenuated pandemic vaccines should not be co-administered.

 

The experts recommended that seasonal and pandemic vaccines can be administered simultaneously, provided both vaccines are inactivated, or one is inactivated and the other is live attenuated. The experts found no evidence that co-administration of vaccines, as recommended, would increase the risk of adverse events.

 

Vaccine safety

 

The experts reviewed early results from the monitoring of people who have received pandemic vaccines and found no indication of unusual adverse reactions. Some adverse events following vaccination have been notified, but these are well within the range of those seen with seasonal vaccines, which have an excellent safety profile. Although early results are reassuring, monitoring for adverse events should continue.

 

Vaccines for pregnant women

 

Concerning vaccines for pregnant women, SAGE noted that studies in experimental animals using live attenuated vaccines and non-adjuvanted or adjuvanted inactivated vaccines found no evidence of direct or indirect harmful effects on fertility, pregnancy, development of the embryo or fetus, birthing, or post-natal development.

 

Based on these data and the substantially elevated risk for a severe outcome in pregnant women infected with the pandemic virus, SAGE recommended that any licensed vaccine can be used in pregnant women, provided no specific contraindication has been identified by the regulatory authority.

 

Vaccines for the southern hemisphere in 2010

 

SAGE also considered vaccines for use in the southern hemisphere during the 2010 winter season. Two options were assessed: a trivalent vaccine, effective against the H1N1 pandemic virus, the seasonal H3N2 virus, and influenza B viruses, and a bivalent seasonal vaccine, effective against H3N2 and influenza B viruses, which might need to be supplemented with a separate monovalent H1N1 pandemic vaccine.

 

The experts concluded that both options should remain available for vaccine formulations in the southern hemisphere, subject to national needs.

Dutch Researchers Question Flu Vaccinations For Kids

 

 

# 3908

 

On the same day that the NIAID study comes out promoting the idea of increased childhood vaccinations to slow antigenic drift of flu viruses (see NIAID Scientists Propose New Explanation for Flu Virus Antigenic Drift ) we get blindsided by a new, contrarian study, that questions the wisdom of vaccinating kids against seasonal flu.

 

Helen Branswell, medical reporter for The Canadian Press, gives us a terrific overview of the controversy.   Follow the link to read it in its entirety.

A hat tip to Crof on Crofsblog  for posting this story.

 

 

 

Do seasonal flu shots impede little kids' ability to fight off pandemic flu?

By Helen Branswell Medical Reporter (CP)

TORONTO — Just when you thought the issue of seasonal and pandemic flu shots couldn't get any more confusing, European researchers are questioning whether it makes sense to vaccinate little kids against seasonal flu.

 

The scientists, from the Erasmus Medical Center in Rotterdam, the Netherlands, argue preventing small children from being infected by - and developing immune responses to - seasonal flu viruses might make them more vulnerable when a flu pandemic rolls around.

 

It's not clear the theoretical concern they raise is true. But other scientists counter that even if it is, it makes more sense to try to protect children from a threat they face every year than one they might face every few decades.

 

"The simple question is should we let young children suffer from a severe and potentially fatal but easily preventable illness, just because there is a theoretical possibility that withholding vaccination might result in a slightly less severe illness sometime in the future?" a pair of Finnish researchers retorted in a counterpoint published with the perspective piece, in the journal Lancet Infectious Diseases.

 

(Continue . . . )

 

The study causing all of the commotion is from the Lancet:

 

 

doi:10.1016/S1473-3099(09)70263-4 

Yearly influenza vaccinations: a double-edged sword?

Original Text

Rogier Bodewes DVM , Joost HCM Kreijtz PhD, Dr Guus F Rimmelzwaan PhD

Summary

Yearly vaccination against seasonal influenza viruses is recommended for certain individuals at high risk of complications associated with influenza. It has been recommended in some countries, including the USA, that all children aged 6—59 months are vaccinated against seasonal influenza. However, it has been shown—mainly in animals—that infection with influenza A viruses can induce protective immunity to influenza A viruses of other unrelated subtypes.

 

This so-called heterosubtypic immunity does not provide full protection, but can limit virus replication and reduce morbidity and mortality of the host. This type of immunity might be relevant to human beings when a new subtype of influenza A virus is introduced into the population, such as the new influenza A H1N1 virus responsible for the present influenza pandemic and the highly pathogenic avian influenza H5N1 viruses that are causing an ever increasing number of human infections with high mortality rates. Preventing infection with seasonal influenza viruses by vaccination might prevent the induction of heterosubtypic immunity to pandemic strains, which might be a disadvantage to immunologically naive people—eg, infants.

NIAID Scientists Propose New Explanation for Flu Virus Antigenic Drift

 

# 3907

 

NIH News released the following report a couple of hours ago, describing new research into how flu viruses mutate and drift antigenically.

 

The news brief below is fairly straight forward, but essentially researchers believe that more antigenic drift occurs in immunologically naïve hosts (such as unvaccinated children) than occurs in adults who have a history of building antibodies.

 

They propose that increasing the vaccination rates in children could slow the rate of antigenic drift. 

 

A fascinating report. 

 

 

---

Reference: SE Hensley et al. Hemagglutinin receptor binding avidity drives influenza A virus antigenic drift. Science. DOI: 10.1126/science.1178258 (2009).

---

 

NIAID Scientists Propose New Explanation for Flu Virus Antigenic Drift

Influenza viruses evade infection-fighting antibodies by constantly changing the shape of their major surface protein. This shape-shifting, called antigenic drift, is why influenza vaccines — which are designed to elicit antibodies matched to each year's circulating virus strains — must be reformulated annually. Now, researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, have proposed a new explanation for the evolutionary forces that drive antigenic drift. The findings in mice, using a strain of seasonal influenza virus first isolated in 1934, also suggest that antigenic drift might be slowed by increasing the number of children vaccinated against influenza.

 

Scott Hensley, Ph.D., Jonathan W. Yewdell, M.D., Ph.D., and Jack R. Bennink, Ph.D., led the research team, whose findings appear in the current issue of Science.

 

“This research elegantly combines modern genetic techniques with decades-old approaches to give us new insights into the mechanisms of antigenic drift and how influenza viruses elude the immune system," says NIAID Director Anthony S. Fauci, M.D."

 

"No one is sure exactly how the antigenic drift of flu viruses happens in people," says Dr. Yewdell. According to the prevailing theory, drift occurs as the virus is passed from person to person and is exposed to differing antibody attacks at each stop. With varying success, antibodies recognize one or more of the four antigenic regions in hemagglutinin, the major outer coat protein of the flu virus. Antibodies in person A, for example, may mount an attack in which antibodies focus on a single antigenic region. Mutant viruses that arise in person A can escape antibodies by replacing one critical amino acid in this antigen region. These mutant viruses survive, multiply and are passed to person B, where the process is repeated.

 

It is not possible to dissect the mechanism of antigenic drift in people directly, notes Dr. Yewdell. So he and his colleagues turned to a classic mouse model system developed in the mid-1950s at the University of Chicago, but used rarely since. The team infected mice with a strain of seasonal influenza virus that had circulated in Puerto Rico in 1934. Some mice were first vaccinated against this virus strain and developed antibodies against it, while others were unvaccinated.

 

After infecting the vaccinated and unvaccinated mice with the 1934 influenza strain, the scientists isolated virus from the lungs of both sets of mice and passed on these viruses to a new set of mice. They did this nine times. After the final passage, the researchers sequenced the gene encoding the virus hemagglutinin protein. Of course, says Dr. Yewdell, gene sequencing was not possible in the mid-1950s, when the nature of the gene was first elucidated, and until very recently, sequencing was expensive and time-consuming. "Now, with automated gene sequencers, sequencing of dozens of isolates is easily done overnight," he says.

 

Sequencing revealed that the unvaccinated mice — which lacked vaccine-induced antibodies — had no mutated influenza viruses in their lungs. In contrast, the hemagglutinin gene in virus isolated from vaccinated mice had mutated in a way that increased the ability of the virus to adhere to the receptors it uses to enter lung cells. Essentially, says Dr. Yewdell, the virus can shield its hemagglutinin antigenic sites from antibody attack by binding more tightly to its receptor.

 

"The virus must strike the right balance, however," Dr. Yewdell says. "Excessively sticky viruses may end up binding to cells lining the nose or throat or to blood cells and may not make it into lung cells. Also, newly formed viruses must detach from infected cells before they can spread to the next uninfected cell. Viruses that have mutated to be highly adherent to the lung cell receptors may have difficulty completing this critical step in the infection cycle."

 

Next, the researchers infected a new set of unvaccinated mice with the high-affinity mutant virus strain that had emerged in the first series of experiments. In the absence of antibody pressure, the virus reverted to a low-affinity form and was once again able to easily infect cells and spread.

 

"We propose a model for antigenic drift in which high- and low-affinity influenza virus mutants alternate," says Dr. Yewdell. In adults — who have been exposed to many strains of influenza in their lifetime and, correspondingly, have a wide range of antibody responses — the virus is pressured to increase its receptor affinity to escape antibody neutralization. When such high-affinity mutants are passed to people — such as children — who have not been exposed to many influenza strains or who have not been vaccinated against flu, receptor affinity decreases. People who have not been exposed to multiple influenza virus strains or who have never been vaccinated against influenza are said to be immunologically naïve.

 

"Our model predicts that decreasing the immunologically naïve population — by increasing the number of children vaccinated against influenza, for example — could slow the rate of antigenic drift and extend the duration of effectiveness of seasonal influenza vaccines," he says.

Japan: Small Number of Adverse Vaccine Reactions

 

 

# 3906

 

Ten days ago Japan began vaccinating medical workers against the Shingata (new) flu, using a domestically produced H1N1 vaccine. To date, more than 850,000 vaccinations have been given.

Out of those, a total of 10 serious adverse reactions have been reported, or about 1 in every 85,000 injections.  All but one case have `mostly recovered’ according to this article.

While this is a little more than double the rate normally seen with seasonal influenza shots, heightened levels of scrutiny for this vaccination drive may be affecting these numbers. 

 

As stated many times before, no drug is completely benign, and side effects from vaccines – while rare – do occur.  

 

Of course, there is considerable risk in going unvaccinated, as evidenced by the thousands of deaths worldwide since this novel H1N1 outbreak began.

 

This from the Yomiuri Shimbun

 

4 more cases of side effects from new-flu vaccine

 

The Yomiuri Shimbun

 

Four more cases of serious side effects have been confirmed among medical workers being vaccinated against the new strain of H1N1 influenza, including anaphylaxis and impaired liver functions.

 

According to the Health, Labor and Welfare Ministry, 10 cases of serious side effects have been confirmed since the vaccination of medical workers began on Oct. 19. The ministry announced the survey results Wednesday.

 

Except for one case the ministry is still investigating, all other patients who developed serious side effects have mostly recovered, the ministry said.

 

"Right now we can say the frequency of side effects [from the vaccine] isn't high," a ministry spokesman said.

 

Among the 10 cases of serious side effects, six--including the four latest cases--occurred from among 850,000 vaccinations administered, or 0.0007 percent.

 

The corresponding ratio for vaccinations against seasonal flu is 0.0003 percent.

 

(Continue . . .)

MMWR: 22 New Pediatric Flu Deaths

 

 

# 3905

 

 

Although we’ll get an update tomorrow in Friday’s FluView report,  today’s release of the MMWR indicates that 22 new pediatric influenza deaths were reported in the United States last week.  

 

Some of those may be from previous weeks, as sometimes there is a bit of lag time in testing and reporting. 

 

But the 5-year weekly average for this time of year is Zero. 

Week 42: 22 new deaths reported
Cumulative 2009: 192 total deaths reported
By states: WI (1), SD (1), GA (1), FL (1), TN (2), TX (9), MT (1), AZ (3), WA (1), OH (1), GU (1)

 

These would be considered extraordinary numbers in the middle of February, to be occurring in October is particularly worrisome.

 

Since August 31st, the total is sadly 74 children lost to this virus.

 

Pediatric influenza deaths are the only notifiable flu deaths in the US, and so we have a much better handle on how many really are occurring around the country.  

 

This is LAST WEEK’S chart (update comes tomorrow 10/30/09).

New Scientist: Swine Flu Myth Busters

 

# 3904

 

The New Scientist debunks 8 dangerous swine flu myths in:

Swine flu: Eight myths that could endanger your life.  

Each myth has a link to a more detailed answer, so by all means follow them.  I’ve only reproduced the openings of the first 3, but all are worth reading.

 

Highly recommended.

 

MYTH 1

The symptoms are like regular flu. You've got it if you've got a fever

Up to half the people who get swine flu never develop a fever, and some suffer from gastrointestinal symptoms as well as more standard flu symptoms. Read more

 

MYTH 2

This is just mild flu. The death rates are even lower than for normal flu

Swine flu is killing young people rather than the very elderly, and although winter is just starting, more young people have already died of flu than normally die over the entire winter. Read more

 

MYTH 3

You're safe as long as you're healthy. Only sick, weak people get really ill

Most of the children who have died of swine flu were perfectly healthy beforehand, and many of the adult victims also had no underlying conditions. Read more

 

A hat tip to @Dutchy123 on Twitter for tweeting this article.

Reports Out Of The Ukraine

 

 

# 3903

 

NOTE: This story has been  Updated

WHO Dispatching Team To Ukraine

Ukraine Update: H1N1 Quarantine

 

 

 

For the past few days newshounds on the flu forums have been busily finding, and translating, articles from the Ukrainian and Russian press regarding an outbreak of an `unknown disease’ in the Ukraine, which has been blamed for as many as 22 deaths.

This disease has been described most frequently as `flu-like’ and `atypical pneumonia’, and so there is a strong likelihood that this is the novel H1N1 `swine’ flu virus – although that has not been established.

 

Translations from Russian to English are problematic at times, and we are seeing conflicting accounts, so until we learn more these reports should be viewed with a certain amount of skepticism.

 

The FluTrackers thread now has in excess of 66 posts over the past three days, as the newshounds compile and analyze these reports. A few excerpts from these reports below:

 

The first story was posted by Dutchy on October 27th.  Bear in mind that these are machine translations from the Russian language:

 

In Ukraine, from complications following an unknown form of flu deaths of seven people

Ternopil. October 27. INTERFAX-UKRAINE - In Ternopil region of Ukraine on October 26 from complications caused by flu, seven people died, said Tuesday the head of the regional health administration Bogdan Oniskiv.

 

At a press conference on Tuesday in Ternopil, he noted that almost all dead - the young, physically healthy people. "

 

He also informed that over the past few days in Ternopil with flu symptoms unknown to the medical institutions sought about 6 thousand people.

 

Over the next 24 hours the number of deaths reported escalated to 20, and we received conflicting reports as to whether this virus was H1N1.   Samples have reportedly been sent to a lab in London, and results are not due back for several days.

 

This report posted by Hogweed.

 

Health Ministry Confirms 20 Lethal Pneumonia Cases In Ternopil, Ivano-Frankivsk And Lviv Regions

(15:59, Wednesday, October 28, 2009)Ukrainian News Agency

The Ministry of Healthcare confirms 20 lethal cases of pneumonia in Ternopil, Ivano-Frankivsk and Lviv regions, first deputy health minister Vasyl Lazoryshynets, has told at a news conference.

 

He said that 95 people were taken to hospitals in Ternopil region since October 13, of them 25 in grave condition and 10 of them died.

In Ivano-Frankivsk region 25 people were taken to hospitals for the same period, seven in grave condition, six died.

 

In Lviv region 6 patients were taken to hospitals since October 1, of them two in grave condition, four died.

 

In his turn, first deputy health minister / chief sanitary officer Oleksandr Bilovol said that a high threshold of incidence rate of acute respiratory viral infection has been recorded for the last week and a half in these regions, specifically in Ternopil region the epidemiological threshold exceeded by one and a half times.

He says that at the moment they are searching for underlying causes of pneumonia for every of the lethal cases.

Bilovol expects results of the research in a week.

 

On Wednesday Vasyl Kniazevych, the health minister, has said that nine cases of death by pneumonia registered in Ternopil region by October 28, and also 95 people treated at hospitals with the same diagnosis.

 

As to the minister, suspicions of the А(H1N1) influenza virus were not confirmed.

 

As Ukrainian News earlier reported, the health ministry formed a commission to study reasons for the uprise in the incidence rate of influenza and acute respiratory viral infections in Ternopil region.

 

There are also conflicting reports over whether quarantines and travel restrictions have been imposed in the region.   Below is an updated report from today, posted by Dutchy.   

 

A couple of notes: The mention of SARS in these reports are an artifact from the translation software, and should be interpreted as ARVI - acute respiratory viral infection  (Hat tip Alert on FluTrackers).  Additionally, the use of Rapid Influenza diagnostic tests (RIDTs) to rule out H1N1 is an unreliable method.

 

In Western Ukraine, the number of deaths from viral pneumonia rises to 22 people, including two children

29. 10. 2009 | Kyiv, October 29. / Corr. ITAR-TASS Galina Nekrasov.

 

Two more deaths due to viral pneumonia registered in Ternopil and Lviv regions. Thus, the number of deaths from an unknown virus in the western regions of Ukraine has reached 22 people, the press service of the Ministry of Health of Ukraine. Almost doubled in the last day of the increased number of hospitalized. Hospitals are more than 130 people, of whom more than 30 in critical condition.

 

In all the western regions of the country set up mobile teams of the ambulance that identify patients and urging people not to engage in self-medicate. "If a patient on the first day, ask for help, then there is a 100 percent chance to save him," said the chief sanitary doctor of Ukraine Alexander Bilovol.

The disease occurs rapidly, beginning with the high, up to 40 degrees, temperature, fever and chills, on the third day there asphyxiation and pulmonary insufficiency, developed bilateral pneumonia and pulmonary edema.

The disease is not treated with antibiotics, only new antiviral drugs, which in pharmacies there. They're centrally transported to hospitals in the region. The cost of one day of treatment the patient is 10 thousand hryvnia / more than 1 thousand dollars.

 

Health Minister Vasyl Knyazevich argues that "rapid diagnosis does not confirm the strain of California virus A/H1N1 / in the three western regions. Analysis of patients sent to the virology laboratory in London. "Ukraine, as one of the countries of the European region, serves the laboratory.

 Obviously an interesting situation, and one that is being watched closely.  The most likely explanation here is the H1N1 virus, but we will have to await laboratory confirmation to know for sure.