Thursday, August 6, 2009

H1N1 Virus Updates






Ottawa reports 4th death related to H1N1 but no more information released



OTTAWA - A fourth person in Ottawa has died after contracting the H1N1 virus.


Ottawa Public Health is releasing no information about the person, only saying the victim had chronic medical conditions.


There have been 361 confirmed cases of H1N1, also known as swine flu, in Ottawa, with 69 people admitted to hospital.


The Public Health Agency of Canada said as of Tuesday that 62 people with the virus had died across the country.


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UPDATE: Canadian swine flu total up to 51


Canada's caseload of the virulent flu strain known as H1N1 reached 51 on Friday as British Columbia and Nova Scotia together reported 10 new cases of the disease described as a "medical condition" by Prime Minister Stephen Harper.


B.C.'s four new cases involved one youngster, one teenager and two adults - all in the province's Lower Mainland, all mild and all involving people who were either recently in Mexico or in contact with people who were, said Premier Gordon Campbell.


While neither the status nor the number of cases in Canada should be considered cause for alarm, the level of worry surrounding a virus that's fuelling fears of a global pandemic is perfectly justified, Campbell told a news conference.


"We expect, and our experts expect, that the number of cases will continue to rise," Campbell said of the province's caseload, which is currently at 15.


"Unfortunately, we may see some deaths. We have deaths from flu every year. It's important for us to recognize that and it's important for us to recognize that, again, there is no reason we can't deal with this constructively and positively if we all pay attention to it."


Much the same warning came from health officials in Nova Scotia, which is where Canada's first cases of H1N1 came to light last weekend, all of them from a private school where a group of students had recently returned from a school trip to Mexico.


Indeed, all the new cases are students from the King's Edgehill private school in Windsor, N.S., said Dr. Robert Strang, Nova Scotia's chief public health officer.


"At this point we're not seeing severe cases such as have been experienced in Mexico," Strang said. The province's total caseload is now 14, he added.


"We do expect to see new cases and we anticipate more in the coming days. As with normal flu, once the number of cases does increase, it is normal to see more severe cases and potentially even some deaths."


Ontario reported four more mild cases, all in the Toronto area, bringing the province's total to 12.


In Alberta, two more mild cases involving two women from Calgary, one a recent returnee from Mexico and the other from Tennessee, brought the total number in the province to eight, said Dr. Andre Corriveau, the province's chief medical officer of health.


Corriveau said health officials have heard that some businesses in Alberta are requiring any staff who have recently visited Mexico to see a doctor before they return to work, a step he described as unnecessary.


"We are appealing to people to be reasonable - not to clog our health-care system unnecessarily."

On Friday, the Catholic Archdiocese of Edmonton said it was asking parishes to make changes to help prevent the spread of infection.

Priests have been asked to stop distributing consecrated wine from the common cup and to encourage parishioners who usually receive communion wafers on their tongue to receive it in their hands instead.

"It is important to note that the Phase 5 WHO alert does not mean a life-threatening health situation in the Archdiocese and that the steps being recommended are precautionary," Archbishop Richard Smith said in his letter to priests.


An official with the Canadian Conference of Catholic Bishops said it was not immediately clear how many of the other 14 Archdiocese across the country are taking similar measures.
At an event in Edgeley, Sask., Harper said he's confident that Canadians, while taking the necessary precautions and eyeing developments with a sense of concern, are not getting carried away.

"My sense is the public is, like ourselves, concerned, but I don't sense a panic," Harper said. "I sense the public is listening very carefully to various advisories and warnings they are getting and responding appropriately and that's what we encourage."


Harper, who was asked about the World Health Organization's decision Thursday to begin referring to the virus by its formal name rather than the more colloquial "swine flu," glanced over his shoulder at an aide for confirmation of the new designation.

"This is obviously a medical condition so it makes sense to refer to it that way and I gather that's a standard that the World Health Organization is now trying to encourage," Harper said.
"The health risks here are to humans; that's the concern ... It is not the health of the hog industry in any way that is at stake here, so we will encourage that terminology."


Strang said all of the Nova Scotia students who had swine flu were now better, after spending at least seven days in isolation, and are no longer infectious.


One of the six students who became infected with swine flu was actually on the trip to Mexico, while the other five caught it after the students came back to Canada. Fifteen students at the school are still in isolation, he added.


Dr. Ken Buchholz, senior physician adviser with Nova Scotia's Department of Health. said there hasn't been a significant increase in the number of people going to emergency departments around the province.


"At this point, the (flu) cases have been mild, and nobody has been hospitalized."




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Should Canada share H1N1 antivirals?


As Canada expects to have enough antiviral drugs for everyone who needs them during an H1N1 pandemic, ethicists ask whether we should consider giving some away to the rest of the world.
The Canadian pandemic plan includes a national stockpile of antiviral drugs that provincial and territorial governments plan to increase to 55 million doses to handle the increased demand for the medication due to the outbreak of the H1N1 influenza virus.



“We’re actually in good shape on antivirals thanks to the foresight of the public health agency,” said Dr. Peter Singer, a bioethicist and director of the McLaughlin-Rothman Centre at the University of Toronto. “That is a good time to reflect on just how lucky we are in relationship to other countries around the world, particularly on the antiviral issue, and maybe a time to begin to reflect on what we can do to help.”


The Public Health Agency of Canada has not yet decided whether to donate any part of its antiviral stockpile to developing countries who are not as well prepared, and said it is waiting for the World Health Organization to officially ask for help.


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Pandemic H1N1 vaccine development 'on track,' WHO vaccine head says


Development of swine flu vaccine is "on track" and some countries may begin administering the vaccine as early as September, the head of the World Health Organization's initiative for vaccine research said Thursday.


Dr. Marie-Paule Kieny said manufacturers have made small batches of the pandemic vaccine and are starting clinical trials to determine that the vaccine is safe and produces a protective response.


Kieny said clinical trials are already started in Australia, China, the United States, Germany and Britain and more will come on line in coming days.
Kieny declined to offer an updated prediction of how much swine flu vaccine will be available, saying at this point too much is unknown. Earlier the WHO had estimated that in a best case scenario, as many as 94 million doses a week could roll off production lines when manufacturing plants are fully engaged in making the vaccine.


"I would really like to avoid to make any projection right now," Kieny said, noting that initially the vaccine yield manufacturers were getting was substantially lower than they get when they make seasonal flu vaccine.


A new, better yielding seed strain has been developed, and shipping to manufacturers started Wednesday. The lab that made it, Britain's National Institute for Biological Standards and Control, says the new seed strain produces a yield on a par with that of seasonal flu vaccine production.


That will have to be confirmed by the manufacturers before revised production estimates could be calculated, Kieny suggested. "We need to see what are the real yields."
As well, she said, results from early clinical trials that show what dose size and number of doses each person needs will allow the WHO to make a better estimate of how much vaccine will be available.

It's one thing to have batches of vaccine made and another to be able to administer the product to people, Kieny warned, saying regulatory agencies in various countries must first license the vaccines.

Kieny gave a rundown of the fast-tracking systems various regulatory agencies have put in place, systems that have been devised in recent years in response to the realization that regulators would need to move swiftly when a pandemic starts.


She stressed that the fast-tracking won't undermine the safety of the vaccines being produced.
But countries using vaccine will need to be vigilant to look for and investigate any reports of adverse events linked to receipt of the vaccine, Kieny said.


The WHO realizes some such reports are inevitable. And while some may be real, others could be what are known as temporal associations - problems that seem like they may have been caused by the vaccine because they occurred after the person got a flu shot but which in reality would have happened regardless.

Kieny said countries will need to rapidly investigate any signals of problems related to the vaccine and communicate any findings quickly to the public.

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