Swine Flu: India's first cell cultured Swine Flu vaccine launched

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BBC NEWS | Health | Swine flu 'shows drug resistance'

Swine flu 'shows drug resistance'

Experts have reported the first case of swine flu that is resistant to tamiflu - the main drug being used to fight the pandemic.

Roche Holding AG confirmed a patient with H1N1 influenza in Denmark showed resistance to the antiviral drug.

David Reddy, company executive, said it was not unexpected given that common seasonal flu could do the same.

The news comes as a nine-year-old girl has become the third to die in the UK with swine flu.

It is understood from her doctors at Birmingham Children's Hospital that she had underlying health conditions. It is not yet known whether swine flu contributed to her death.

Meanwhile, the Department of Health has announced a big jump in the number of patients in England confirmed with swine flu - up 1,604 since Friday, taking the UK total so far to 5,937.

Experts have been using tamiflu, also known as oseltamivir, in a bid to stop the H1N1 spreading in communities.

If taken early, it ensures that symptoms are mild and reduces the chance of a victim giving the illness to someone else.

This first reported case of resistance developed in a swine flu patient taking Tamiflu.

Watch and wait

Mr Reddy stressed that there were no signs of a tamiflu-resistant strain of H1N1 circulating in the community.

This is in contrast to seasonal H1N1 flu where a Tamiflu resistant strain emerged last year and is now widely circulating.

Experts fear if this were to happen, it could render tamiflu ineffective.

Another antiviral drug, called zanamivir or Relenza, made by GlaxoSmithKline, is also effective against swine flu.

The UK government has been stockpiling these antiviral drugs and currently has enough to treat half of the population, with a contract to bring that up to 80% as soon as possible.

Supplies of flu vaccine have also been ordered and the first doses could be administered in the autumn.

A spokeswoman for the Health Protection Agency said: "The Health Protection Agency continues to watch for antiviral resistance and will be carrying out regular sample testing throughout this outbreak.

"We have been monitoring antiviral drug resistance since the beginning of this outbreak. Routine sampling in the UK has shown that there is currently no resistance to oseltamivir or zanamivir."

Virologist Professor John Oxford said: "I'm not surprised about this finding. The question is whether it is going to spread. We will soon know the answer."

 

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Will two flus mix in Indonesia? Experts worry | Reuters

Will two flus mix in Indonesia? Experts worry
Mon Jun 29, 2009 2:00pm EDT

By Olivia Rondonuwu

JAKARTA (Reuters) - Indonesia's first cases of the new H1N1 flu have raised concerns that if the virus spreads it could combine with the entrenched and deadly H5N1 avian influenza to create a more lethal strain of flu.

Even if this worst-case scenario did not occur, experts say populous, developing countries such as Indonesia, India or Egypt, where healthcare systems can be rudimentary, will suffer more deaths from the new virus.

Indonesian Health Minister Siti Fadillah Supari, who confirmed six new H1N1 cases on Sunday, said she was concerned about H1N1, widely known as swine flu, "marrying" with H5N1 avian flu.

Influenza viruses not only mutate quickly and unpredictably, but they can swap genes, especially if a person or animal becomes infected with two strains at once. The new H1N1 strain is itself a mixture of various strains, genetic tests show.

H5N1 bird flu has been circulating in Asia for years and has hit Indonesia harder than any other country. Although it only rarely infects people, it has killed 262 out of 433 infected globally since 2003, with 141 of those cases in Indonesia.

"We are scared because we are the warehouse of the world's most virulent H5N1," Supari said.

"I am worried if the viruses encounter each other in the field," C.A. Nidom, the head of the Avian Influenza lab at Airlangga University in Surabaya, said.

The World Health Organization declared a pandemic of H1N1 swine flu earlier this month and said the virus causes a moderately severe flu, spreading very easily from person to person. H5N1 spreads mostly from a bird to a person and stops there, but is far deadlier.

The mortality rate for H1N1 is 0.2 percent, according to a study in the New England Journal of Medicine, while for H5N1 it is just over 60 percent.

SERIOUS THREAT

Scientists say usually as a virus becomes more transmissible from one human to another it also becomes less deadly, although this is not guaranteed.

But Kamaruddin Zarkasie of Indonesia's Bogor Agriculture University said he felt the risk the two viruses might combine was only a random possibility.

Even if they do not, H1N1 may be a serious threat, other experts said.

Ben Cowling, public health expert at the University of Hong Kong, said people with serious infections who would be admitted to hospitals in developed countries and survive might die in poorer countries.

"It would be reasonable to say the mortality rate in underdeveloped settings is likely to be more comparable to the ICU (admission) rate in developed settings, or five times higher than the mortality rate in developed settings," Cowling said.

"In poorer parts of India and China ... people are nutritionally less able to fight infection and they don't have the drugs that we have in major cities," said Robert Booy, head of clinical research at the University of Sydney's National Center for Immunization Research & Surveillance.

H1N1 has killed more than 300 people and there have been at least 67,000 confirmed cases worldwide.

(Additional reporting by Karima Anjani and Tan Ee Lyn in Hong Kong; Editing by Ed Davies and Maggie Fox)

 

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AFP: Swine flu fears hit Wimbledon, drug resistance reported

Swine flu fears hit Wimbledon, drug resistance reported

6 hours ago

LONDON (AFP) — Swine flu fears hit the Wimbledon tennis tournament Monday as global infections topped 70,000 and Denmark reported the first case of resistance to the key Tamiflu drug used to treat the virus.

With the death toll from the pandemic at 311 and total cases at 70,893, according to the WHO, more countries reported their first A(H1N1) infections and Indonesia planned to ask some people arriving there to wear masks.

Australian researchers said a vaccine could be ready in months. However, Danish officials reported that a patient showed resistance to Tamiflu, considered a key treatment for the virus by the World Health Organisation.

The Danish woman is no longer suffering from the illness, the Danish Institute of Serology said.

She had been in direct contact with a swine flu victim and was given a dosage of Tamiflu as a preventative measure, but she still contracted the virus.

That led doctors to give her another type of medication, Relenza, made by British pharmaceutical giant GlaxoSmithKline.

Nils Strandberg, the institute's director, said he was satisfied with methods used to monitor swine flu, adding that "the spontaneous mutation of a flu virus is not unusual".

Swiss drugs company Roche, which makes Tamiflu, said the patient's resistance was expected and likely an individual case.

"It doesn't mean the circulating virus is resistant to Tamiflu," said David Reddy, Roche's pandemic task force leader.

The worries at Wimbledon came with play intensifying as the tournament entered its second week. Organisers said some staff members had reported "flu-like" symptoms but the competition would continue as normal.

Club sources told AFP a handful of ball boys and girls were affected but nobody had been confirmed as having contracted the virus.

Venus Williams, the defending Wimbledon ladies' singles champion, said she was not worried.

"I just got a letter. I haven't read it. But I guess there's sicknesses all around. Hopefully the players won't get sick," the US tennis champ said.

Nearly 6,000 swine flu cases have been diagnosed in Britain, the Department of Health reported, and a hospital said Monday a nine-year-old girl had become the third person with the virus to die.

The girl had underlying health problems and it was unclear whether swine flu had contributed to her death, Birmingham Children's Hospital said.

Elsewhere, the virus first discovered in late March continued its spread.

According to the WHO figures released Monday, the United States showed the largest increase in cases, bringing the total to 27,717, including 127 deaths -- but that count may be massively low.

US health authorities said Friday that at least one million people in the United States had had swine flu.

The US Centers for Disease Control and Prevention arrived at its figure based on computer models and surveys of communities known to have been hard hit.

Australian researchers said Monday a vaccine could be ready in months as the country, the worst-hit in Asia-Pacific, reported two more deaths linked to the virus, taking the total to six.

University of Queensland scientists said they had produced the country's first batch of a vaccine developed in the United States.

Researcher Anton Middelberg said the company behind the FluBlok vaccine -- Connecticut-based Protein Sciences Corporation -- planned to run clinical human trials in the United States, Mexico and Australia.

"It all depends on the regulatory process but I'd say we are months away from a swine flu vaccine," Middelberg said.

Highlighting the virus's spread, Nepal, the Indian Ocean island of Mauritius, Kenya and Bosnia all reported their first cases Monday.

In Indonesia, the health minister said the government would ask all those arriving from swine flu-affected countries to wear masks for at least three days.

The presence of the virus was confirmed in Indonesia only last week and so far four of the eight known cases have been foreigners.

Health Minister Siti Fadilah Supari said the government would not enforce the precaution, which could damage the country's stuttering tourism industry.

"You can't expect people to wear masks when they're swimming," Supari said.

 

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http://www.nytimes.com/2009/06/30/health/30glob.html?hpw

Drug-Resistant Flu Strain Turns Up In Denmark but Doesn’t Last Long

By DONALD G. McNEIL Jr.
Published: June 29, 2009

The first case of swine flu resistant to the antiviral drug Tamiflu has been found in Denmark, according to Danish health officials.

The patient appears to have recovered without infecting anyone else, and experts said the recent history of Tamiflu resistance made it unlikely that the short-lived Danish strain would have been good at spreading to others.

An executive of Roche, the Swiss maker of Tamiflu, held a telephone news conference to describe the progress of the Danish patient, who apparently developed the resistant strain while being protectively treated with a low Tamiflu dose because a close contact had the swine flu. Doctors switched treatment to a different but related drug, Relenza, and the patient recovered.

In the past, Tamiflu-resistant strains of the seasonal flu have been found in Japan, which has used more than half the world’s supply of the drug each year. But those strains were weak and did not spread. A Tamiflu-resistant strain of the H5N1 bird flu was also isolated from a Vietnamese patient being treated with low-dose Tamiflu in 2005, but it also died out.

Tamiflu resistance that did spread in seasonal flu emerged last year from a spontaneous mutation known as H274Y on the N gene. The mutant strain dominated the seasonal H1N1 flu during the past flu season in the United States, before swine flu was discovered in Mexico.

Virologists fear swine flu will soon pick up resistance by merging with seasonal H1N1 flu, perhaps in the Southern Hemisphere, where the flu season is just beginning.

 

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Roche finds 1st case of H1N1 resistance to Tamiflu | Reuters

Roche finds 1st case of H1N1 resistance to Tamiflu
Mon Jun 29, 2009 1:58pm EDT

ZURICH (Reuters) - A patient with H1N1 influenza in Denmark showed resistance to Roche Holding AG's Tamiflu, the main antiviral flu drug, a company executive said on Monday.

"While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call on the Danish case. "This is the first report we have of it in H1N1."

The World Health Organization has raised its pandemic flu alert on the H1N1 flu virus to phase 6 on a six-point scale, indicating the first influenza pandemic since 1968 is under way.

Common seasonal flu can resist Tamiflu and Reddy said a case of resistance in H1N1 was not unexpected, adding Roche has been working on strategies to counter such a development.

(Reporting by Sam Cage and Paul Arnold; Editing by David Holmes)

 

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AFP: Nepal reports first swine flu cases

Nepal reports first swine flu cases

8 hours ago

KATHMANDU (AFP) — Nepal has recorded its first cases of swine flu, in three members of a family living in the United States who are visiting their homeland, the health ministry said Monday.

The couple and their eight-year-old son arrived in Nepal via Doha on June 21 and were tested for the virus after the boy complained of fever, the ministry said.

"A US-based non-resident Nepali couple and their son have been diagnosed with the pandemic H1N1 2009 virus," said ministry official Manas Kumar Banerjee.

"The father, 42, mother, 38, and their eight-year-old son, were all diagnosed with swine flu. Infection was suspected after the eight-year-old boy complained of fever."

Samples of their blood have been sent to a World Health Organization (WHO) laboratory for confirmation, the ministry said.

Authorities in landlocked Nepal announced earlier this month they were stepping up checks at borders and airports after India reported its first swine flu cases.

The disease has infected nearly 60,000 worldwide and killed 263, according to the WHO.

 

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Only a flight away? Swine flu followed route map | Health | Reuters

Only a flight away? Swine flu followed route map
Tue Jun 30, 2009 4:18am IST

A Belgian student repatriated from Mexico poses with a
sombrero and a surgical mask upon her arrival at Brussels
Airport May 5, 2009.

REUTERS/Thierry Roge

By Maggie Fox, Health and Science Editor

WASHINGTON (Reuters) - Health experts are fond of saying any new disease is just a flight away from anywhere, and a report published on Monday shows the new strain of H1N1 flu followed the airline route map as it spread around the globe.

The swine flu virus spread first and quickest in March and April in the United States and Canada -- where 80 percent of airline passengers traveled in March and April of 2008, researchers at St. Michael's Hospital in Toronto found.

Dr. Kamram Khan of St. Michael's and colleagues used International Air Transport Association data for their study. They said travel patterns were also similar in 2007 and therefore likely to be similar in 2009.

"This work provides the world with a potent early warning system for emerging infectious diseases," Dr. Michael Gardam of the Ontario Agency for Health Protection and Promotion said in a statement.

"Our analysis showed that in March and April 2008, a total of 2.35 million passengers flew from Mexico to 1,018 cities in 164 countries," Khan and colleagues wrote in the New England Journal of Medicine and published at h1n1.nejm.org/.

Los Angeles had the most travelers, with 221,494 passengers arriving from Mexico in March and April of 2008. New York followed with 126,345. The first non-U.S. city was Toronto, No. 12, with 44,854 passengers arriving from Mexico.

The World Health Organization has confirmed 70,893 cases of the new H1N1 swine flu pandemic, with 311 deaths. However, U.S. health officials last week said there were likely at least 1 million cases there alone. Iraq, Lithuania, Monaco and Nepal all confirmed their first cases on Monday.

The first cases were detected in two California children in April, but tests showed the first known infections were in Mexico. By the time they had identified a new virus, U.S. officials said it had spread too far and too fast to try to stop it.

Other countries tried measures to slow its spread, but WHO declared a pandemic -- a global epidemic -- this month.

"For the first time, we can quickly integrate information about worldwide air traffic patterns with information about global infectious disease threats," Khan said.

"What this means is that cities and countries around the world can now respond to news of a threat earlier and more intelligently than ever before."

The researchers said the United States receives more than 76 million international visitors from around the world every year and the United States and Canada together generate and receive about one-sixth of the global volume of international air traffic.

 

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AFP: Young, healthy Canadians worst-hit by swine flu: official

Young, healthy Canadians worst-hit by swine flu: official

3 hours ago

OTTAWA (AFP) — Canadian health officials expressed alarm Monday that the swine flu is affecting younger people hardest.

Preliminary data shows that the A(H1N1) virus has mostly infected people under the age of 20 in Canada, and relatively few people over 65 have contracted it.

During seasonal influenza outbreaks, it is usually the elderly who account for 25 percent of infections, and most deaths.

"So this is quite different," Chief Public Health Officer David Butler-Jones told a press conference.

"The vast majority of the cases continue to be mild, at least mild for influenza, but we are seeing some pockets of more severe illness," he said.

"Although we do expect some cases to be severe in any influenza outbreak, especially when there is underlying factors such as chronic lung disease or diabetes, there are some cases (now) where the individual was previously healthy before catching this virus and rapidly has progressed to severe illness and required a ventilator," he said.

"We're obviously concerned by these severe cases," he added.

Butler-Jones said health authorities are closely monitoring the severe cases to try to understand why some people are suffering worse symptoms than others.

He suggested "the virus itself may be changing and becoming more virulent," or there may be "immunity differences" or other factors that could account for the differences.

But "we don't have an answer yet," he said. "We're still speculating, (and) there is a whole range of possibilities that are being looked at."

Canada has confirmed 7,983 cases of swine flu nationwide, the third-largest number in the world, including 636 requiring hospitalization, and 25 deaths.

An A(H1N1) flu vaccine is being developed and is to be available by late October, officials said.

Meanwhile, Health Minister Leona Aglukkaq is to travel to the United States and Mexico in the coming days to discuss "lessons learned" so far in this pandemic, she said.

 

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Links of Xinhua on Swine Flu spread:

Switzerland to increase border controls to fight against A/H1N1 flu_English_Xinhua

Egypt reports five more cases of A/H1N1 flu_English_Xinhua

Regards

 

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Moroccan woman is Spain's first swine flu death - Europe - World - The Times of India

Moroccan woman is Spain's first swine flu death
30 Jun 2009, 1511 hrs IST, AFP

MADRID: A 20-year-old Moroccan woman has died at a Madrid hospital, becoming Spain's first swine flu fatality, the Gregorio Maranon hospital
announced on Tuesday.

The woman, who suffered from asthma, died at dawn of a respiratory illness provoked by the A(H1N1) flu, said a health ministry statement.

The woman, who was seven-months pregnant when she arrived at the hospital, had been receiving treatment for several days.

When her condition deteriorated Monday, doctors carried out a Caesarean delivery of the baby, who was in good health and unaffected by the virus, said the ministry statement.

"Health minister Trinidad Jimenz will give a press conference to announce the death of the young woman," said a hospital spokeswoman.

According to the latest health ministry figures, issued on Tuesday, 717 people have been infected with the A(H1N1) virus in Spain since it first appeared.

One other patient is being treated in a hospital in Catalonia, northwest Spain, and is in a serious condition.

Spain was the first European country to confirm a case of the A(H1N1) virus.

The latest global figures issued by the World Health Organisation on Monday gave the number of recorded swine flu cases as 70,893 worldwide, with 311 deaths, since the outbreak started in late March.

But some countries are no longer keeping track of all cases recorded.

And US health officials have said that while their official figures record 27,717 cases including 127 deaths, the real figure was probably at least a million -- 50 times more than actually reported.

 

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AFP: China apologizes to Mexico for tough swine flu stand

China apologizes to Mexico for tough swine flu stand

47 minutes ago

CANCUN, Mexico (AFP) — China's Health Minister Chen Zhu Friday apologized to his Mexican counterpart for failing to warn him about the tough measures Beijing imposed on Mexicans to combat swine flu.

"I regret that I did not talk first" to Minister Jose Angel Cordova, Chen said on the sidelines of a meeting in Cancun about the swine flu pandemic.

Beijing quarantined dozens of Mexicans at the height of the A(H1N1) outbreak, cut flights to Mexico and barred pork imports.

The measures were angrily denounced in Mexico, which was the center of the swine flu outbreak that has since spread around the world, and been declared a pandemic by the World Health Organization (WHO).

In May Mexican authorities had to charter a plane to repatriate 136 of its nationals from China after they were thrown into isolation.

Chen said such measures were not aimed "against the people" but sought to "reduce the number of infections linked to international travel during the first wave of the pandemic and to win time to battle an imminent second wave."

He also thanked Mexican authorities for sharing information about the flu outbreak in a transparent way, "which helped trigger the international reaction."

The A(H1N1) virus has already infected some 77,201 people in 120 countries and led to 332 deaths, according to the latest WHO figures.

 

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AFP: WHO sees swine flu tailing off in summer

WHO sees swine flu tailing off in summer

9 hours ago

GENEVA (AFP) — The World Health Organisation still expects the swine flu pandemic to subside in the northern hemisphere over the summer, despite its persistence in the likes of the United States and Britain.

Sylvie Briand, interim head of the WHO's influenza programme, said that cases of flu should still be expected but transmission would slow down thanks to the combined impact of the heat and school holidays.

"First of all there's a climactic aspect, knowing that flu viruses survive better in the cold than in the heat," Briand told AFP.

"The other important element is the density of contact between people. Children are on holiday and we don't have the outbreaks in schools like we had in the United States at the beginning of the epidemic," she added.

Even if the influenza A(H1N1) virus is new, "I think we will nonetheless have the same seasonal nature and transmission will decline in the northern hemisphere this summer, with a weak proportion of severe cases," Briand said.

England's Health Secretary Andy Burnham said Tuesday that 100,000 cases a day could occur across England, Northern Ireland, Scotland and Wales by the end of August if the current infection rate is maintained, stressing it was a projection.

In Washington, the White House said it would hold a high-level meeting next week bringing together top government officials to prepare for the possibility of a more severe outbreak of A(H1N1) influenza.

The meeting was called after the US Centers for Disease Control and Prevention (CDC) estimated that at least one million people in the United States have had swine flu, basing the projection partly on computer models.

British authorities have indicated that officially reported infections may fall well short of the true number of cases.

At the WHO Briand suggested this was largely expected.

"Of course, because there are already a lot of cases where people have few symptoms where they just have a light cough and don't go to the doctor," she said.

"There are even asymptomatic cases of people who are carrying the virus and do not even know it."

Briand said the WHO was thinking of ending its global reporting of laboratory-confirmed cases of swine flu in each country, because it had become "almost unmanageable" to confirm all the cases.

"This data does account for a certain reality and especially the number of countries infected, which shows that most of the earth is now infected," said Briand.

However, "after a certain moment, counting is of little interest and represents just a considerable loss of time for countries," she explained.

The latest data released by the WHO Friday showed that 125 countries and territories have been infected since the new A(H1N1) influenza virus was uncovered in Mexico and the United States last April

Some 89,921 cases were confirmed by laboratory tests, including 382 deaths.

 

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BBC NEWS | UK | England | West Midlands | Tamiflu policy was 'indefensible'

Tamiflu policy was 'indefensible'

Welford Primary School in Birmingham
was among places affected

Senior public health doctors in Birmingham have criticised the policy of giving tamiflu to patients without swine flu as "indefensible".

Jacky Chambers at Heart of Birmingham NHS Primary Care Trust, said the policy applied by the Health Protection Agency (HPA) was "inconsistent and confused".

The policy appeared to be politically driven, the doctor said in an open letter to the British Medical Journal.

The HPA said it was especially cautious initially when information was limited.

However, Dr Chambers, the trust's director of public health, said the policy had been ineffective and not based on any credible evidence.

She said in Birmingham decisions over children receiving prophylaxis (anti-viral drugs for preventative means) had "varied between the whole school, no school and single classes".

She wrote in some cases tamiflu had been given to "pupils sitting within one metre" of someone with the virus and in others to pupils "listed on the school register as having medical conditions (which include those who wear glasses)."

'Potential harm'

Dr Chambers wrote: "Mass prophylaxis of healthy people with antiviral drugs is an irrational, indefensible and ineffective response".

She also wrote such policies may promote "bad hygiene practices" because children treated with tamiflu appeared to have later developed swine flu symptoms and returned to school still unwell.

Dr Chambers added: "The time has come for the public health community to return to some basic principles for managing this pandemic and minimising potential harm."

She said these principles included early and rapid treatment of high-risk patients and and educating people about how to prevent the virus's spread.

Birmingham public health consultant Andrew Rouse added his concerns on the use of tamiflu saying that consent was not always clearly obtained.

He said: "I do not know but suspect that 10% of recipients will get nausea, vomiting, diarrhoea, abdominal pain and headaches.

He added that small numbers of people could develop conditions such as hepatitis and allergic reactions.

'Limited data'

Welford Primary School in Handsworth shut in May with nearly 200 people connected to the school diagnosed with the virus. Other schools in the region have also been affected.

Last month Birmingham became the first place in the UK to move to the "treatment phase" after health officials said the virus could no longer be contained in the city.

And on Thursday, the "containment phase" was abandoned across the UK and with it the mass provision of tamiflu.

The HPA said it had to be cautious in its initial assessment of the swine flu threat.

"HPA's response was influenced by limited data coming out of Mexico and the US, where it seemed to have caused a disproportionate number of deaths and was very infectious in schools," a spokeswoman said.

"Our initial approach had to be highly precautionary. It would have been irresponsible for it to have been otherwise."

She said individual risk assessments in schools had always considered a number of issues and aimed to limit illness in children, delay swine flu's wider spread and give the HPA time to find out more about the virus.

 

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AFP: Tamiflu resistant swine flu case found in HK: govt

Tamiflu resistant swine flu case found in HK: govt

4 hours ago

HONG KONG (AFP) — Hong Kong on Friday detected a strain of swine flu that was resistant to Tamiflu, the main anti-viral flu drug, the health department reported on its website.

The statement said the resistant strain of influenza A (H1N1) was detected during routine tests of its sensitivity to anti-virals.

"This is the first time Tamiflu resistance in HSI virus (has been) found in Hong Kong," a spokesman said.

The case came as the Japanese health ministry said doctors had detected the second case worldwide of a patient resistant to Tamiflu, widely used to treat the illness.

In the Hong Kong case the resistant virus was isolated from a specimen taken from a 16-year-old girl who arrived in the southern Chinese city from San Francisco last month.

She was admitted to hospital and opted not to take Tamiflu, the spokesman said, but was discharged after a week.

The strain is not resistant to the other anti-viral drug, Relenza, the health department said.

A spokeswoman for Swiss pharmaceuticals giant Roche, which makes Tamiflu, said the company had been informed of the case and called it "normal."

"It is absolutely normal," she said, adding that "0.4 percent of adults develop resistance" to Tamiflu.

Last month, authorities ordered all primary schools in Hong Kong to be closed for two weeks after the first cluster of local swine flu cases was found.

When Hong Kong discovered its first case, in early May, health authorities quarantined around 300 guests and staff at a hotel where the carrier, a Mexican, had briefly stayed.

Hong Kong is particularly nervous about infectious diseases following the outbreak of the SARS virus in 2003, which killed 300 people here and a further 500 around the world.

The latest numbers from the World Health Organization, released on Wednesday, showed 77,201 reported swine flu cases, with 332 deaths.

In Japan, the health ministry said doctors in Osaka prefecture had identified a woman who was resistant to Tamiflu -- the second such case, after one found in Denmark.

The Japanese woman had since been treated with Relenza and was recovering, Kyodo news agency reported Thursday, citing the health ministry.

In China, furious relatives of a woman who died while being treated for suspected swine flu stoned an ambulance in a rampage at a hospital in the eastern city of Hangzhou, state news agency Xinhua reported.

Initial reports stoked fears she might be the first person in China to die from swine flu, but police said on Friday that an autopsy had shown she died of an electric shock.

Xinhua reported that the woman had shown no symptoms of swine flu at the time of death, barring an occasional cough.

 

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Fourth person in Britain dies after contracting swine flu - Telegraph

Fourth person in Britain dies after contracting swine flu

A teenager in London has become the fourth person in Britain to die after contracting swine flu, it has emerged.

by Rebecca Smith, Medical Editor
Published: 3:00PM BST 03 Jul 2009

Chief Medical Officer Liam Donaldson says Britain has a massive stockpile of
Tamiflu. Photo: REUTERS

The 19-year-old man from south London, had 'serious' underlying health problems and it was confirmed after he had died that he had contracted swine flu.

The latest death comes after ministers warned there will be 100,000 new cases of swine flu per day by the end of next month.

Despite the warnings, new research has shown that the public is ignoring advice on how to limit the spread of the virus by washing hands more frequently or disinfecting surfaces more regularly.

Dr Simon Tanner, director of public health for London, said: "There are people out there in the community, and we've talked about one today – precious individuals that have got really difficult medical conditions – who are particularly vulnerable when the population has a virus like this in it."

"We've all got a responsibility for their sake," he said.

Jacqui Fleming, 38, of Glasgow, was the first person in the UK to die after contracting the virus last month.

The second victim was a 73-year-old man from the Inverclyde area of Scotland. Then a week ago, six-year-old Sameerah Ahmad became the youngest UK victim to date.

All the people who have died after contracting swine flu already suffered from underlying health problems.

Sir Liam Donaldson, who confirmed yesterday that the UK has moved past the stage of containing the swine flu outbreak and into the "treatment phase", said there was no need for people to resort to the internet to self-medicate.

Sir Liam said: "There's generally a growth in people ordering drugs from the internet worldwide and there's a lot of concern among health authorities that people might buy counterfeit drugs.

"I think this is a similar situation – people shouldn't buy Tamiflu from the internet.

"We have got a massive stockpile in this country and everybody can have access to it through the National Health Service."

Meanwhile research carried out by the Institute of Psychiatry at King's College London and the Health Protection Agency has found that three quarters of people are not concerned about the outbreak of H1N1 and two thirds have not followed any of the measures advised to limit its spread.

A telephone survey of 997 adults between 8 and 12 May asked nine questions including if they had followed advice to wash hands more frequently, increase cleaning of surfaces and discuss with friends and relatives what to do if they fell ill.

Two thirds had not done any of these things.

Being uncertain about the severity of the outbreak and believing that it had been exaggerated were associated with a lower likelihood of change, lead author James Rubin, senior research fellow at the Institute of Psychiatry wrote in the British Medical Journal online.

 

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The Press Association: 64 more have swine flu in Scotland

64 more have swine flu in Scotland

1 hour ago

Another 64 people have been diagnosed with swine flu in Scotland, bringing the total to 1,325.

Most of the new cases of the H1N1 virus are in Greater Glasgow and Clyde NHS area, which has seen the worst outbreaks in Scotland.

Six people are in hospital with the virus and three of the new cases are travel-related.

 

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The Press Association: Swine flu death toll rises to four

Swine flu death toll rises to four

6 hours ago

A 19-year-old man has been confirmed as the first person in London to die after contracting swine flu.

The teenager from south London, who suffered serious underlying health problems, tested positive for the virus following his death on Wednesday.

He is the fourth person with swine flu to die in the UK.

The latest death comes amid warnings that the number of cases could soar to 100,000 a day by the end of next month.

Earlier the Government's chief medical officer warned the public to avoid panic-buying "counterfeit" anti-swine flu drugs online.

Sir Liam Donaldson, who confirmed on Thursday that the UK has moved past the stage of containing the swine flu outbreak and into the "treatment phase", said there was no need for people to resort to the internet to self-medicate.

He said Britain had a massive stockpile of Tamiflu and would be one of the first countries to have access to a vaccine, with the first supplies arriving at the end of next month.

Sir Liam told GMTV: "There's generally a growth in people ordering drugs from the internet worldwide and there's a lot of concern amongst health authorities that people might buy counterfeit drugs.

"I think this is a similar situation - people shouldn't buy Tamiflu from the internet.

"We have got a massive stockpile in this country and everybody can have access to it through the National Health Service."

 

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BBC NEWS | Americas | WHO warns swine flu 'unstoppable'

WHO warns swine flu 'unstoppable'

The UN's top health official has opened a forum in Mexico on combating swine flu by saying that the spread of the virus worldwide is now unstoppable.

World Health Organization head Margaret Chan added that the holding of the meeting in Cancun showed confidence in Mexico, which has been hard hit.

The WHO says most H1N1 cases are mild, with many people recovering unaided.

As the summit opened, the UK alone was projecting more than 100,000 new cases of H1N1 a day by the end of the summer.

As the peak of the flu season approaches in South America, some areas have declared a public health emergency.

El Salvador reported its first death from swine flu, a day after Paraguay reported its first fatality.

'Mild symptoms'

"As we see today, with well over 100 countries reporting cases, once a fully fit pandemic virus emerges, its further international spread is unstoppable," Dr Chan said in her opening remarks.

She stressed that the overwhelming majority of patients experienced mild symptoms and made a full recovery within a week, often in the absence of any form of medical treatment.

The exceptions, she said, were pregnant women and people with underlying health problems, who were at higher risk from complications from the virus and should be monitored if they fell ill.

"For a pandemic of moderate severity, this is one of our greatest challenges: helping people to understand when they do not need to worry, and when they do need to seek urgent care," Dr Chan said.

Turning to the summit venue, the WHO chief added: "Mexico is a safe, as well as a beautiful and warmly gracious, place to visit."

Leaders and experts from 50 countries are in Cancun for the two-day meeting to discuss strategies for combating the virus.

It has been more than two months since the initial alert over swine flu.

Since then, the H1N1 virus has entered more than 100 countries, infected more than 70,000 people and killed more than 300 worldwide.

Authorities across South America are becoming increasingly concerned as the peak flu season approaches, the BBC's Andy Gallacher reports from Cancun.

Schools across Argentina have sent students home and pregnant women have been told they can take two weeks off work to avoid contracting the virus.

It is hoped the Cancun meeting will address many of the issues that might help slow the spread of swine flu but, our correspondent adds, many people are concerned that an effective vaccine has still not been developed.

 

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BBC NEWS | Health | Warning over fake Tamiflu sales

Warning over fake Tamiflu sales

People should not buy anti-flu drug Tamiflu over the internet without a prescription, experts have warned.

The government's chief medical officer said Britain had a "massive" stockpile of genuine Tamiflu.

The drug, used in suspected cases of swine flu, has now overtaken Viagra as the subject of the most junk e-mails, the Royal Pharmaceutical Society says.

But the supplies offered are often fake, with buyers getting sugar or rat poison instead of the drug.

Sir Liam Donaldson said in an interview with BBC Breakfast: "The whole field of counterfeit drugs is becoming a much bigger problem, not just with Tamiflu.

"So my advice is don't buy it , you don't need to. We have got the biggest stockpile in the world and even worse than that you might end up with something that is poisonous and dangerous."

He said the NHS was well prepared to treat the increasing number of swine flu cases that would come with the winter.

"As we move towards the flu season we will see many more cases. That's what we expected. People should not be concerned."

He said: "The NHS will be stretched, it will be under pressure. But we have good plans in place both locally and nationally to deal with this."

Sir Liam confirmed a swine flu vaccine would be available towards the end of August and he said there would be enough for half of the population through the winter, up to Christmas.

The Royal Pharmaceutical Society's research suggests more than two million people regularly buy medicine over the internet. However, much of that trade is legal.

A spokesman, David Pruce, said: "We now think that Tamiflu is the most spammed medicine on the internet. It's taken over from Viagra. Most of that Tamiflu could well be fake. If it's fake it could range from simple sugar to rat poison."

Meanwhile, the government says the rising numbers of swine flu cases mean trying to contain the virus is no longer an option.

Ministers said the emergency response would now move to a new "treatment" phase across the UK as there may soon be 100,000 new cases a day.

Consequently, anti-flu drugs will no longer be given to the close contacts of those infected nor will lab testing be done to confirm cases.

 

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BBC NEWS | Health | Swine flu 'cannot be contained'

Swine flu 'cannot be contained'

The rising numbers of swine flu cases mean trying to contain the virus is no longer an option, the government says.

Ministers said the emergency response would now move to a new "treatment" phase across the UK as there may soon be 100,000 new cases a day.

It means anti-flu drugs will no longer be given to the close contacts of those infected nor will lab testing be done to confirm cases.

The move has been made to relieve the pressure on the health service.

The announcement, which comes into effect immediately, has long been expected.

It does not mean the pandemic virus is becoming more deadly, just that it can no longer be contained.

When people are displaying symptoms, they should contact the NHS by phone, the government said.

If doctors believe the person is suffering from swine flu they will be told to stay at home and be given a voucher which a friend or family member can take to a drug collection point, such as a pharmacy.

Although GPs will have the discretion not to prescribe anti-viral drugs.

Some experts believe the drugs should just be targeted at the most vulnerable as the virus is quite mild and overuse can lead to resistance.

Ministers rejected this option, but said doctors may want to limit use in certain situations such as where patients are suffering milder symptoms.

The need for lab testing had already been lifted in several hotspots, such as London and Glasgow.

But the rest of the UK had been operating a containment strategy, which meant cases had to be confirmed and drugs were also offered to close contacts in a bid to prevent flu developing.

It also led the closure of several schools. This will still be an option under the new phase, but shut downs will not be routine.

Andy Burnham, the health secretary in England, said: "The national focus will be on treating the increasing numbers affected by swine flu.

"Cases are doubling every week and on this trend we could see over 100,000 cases per day by the end of August."

'Worthwhile'

But he said the attempts to contain the virus had been worthwhile.

"Our efforts during the containment phase have given us precious time to learn more about the virus."

He confirmed vaccines should be available from next month, with 60m doses available by the end of this year.- enough for 30m people.

Enough vaccine to cover the whole UK population is in order.

Scottish Health Secretary Nicola Sturgeon announced similar changes to the flu strategy at a simultaneous briefing in Edinburgh.

She said: "We've always said it would be impossible to limit the spread of what is a contagious virus indefinitely."

There have been more than 7,000 confirmed cases in the UK since the first outbreak in April. In England, 458 more cases were reported on Thursday.

Three people have died, but all had underlying health problems.

However, it is thought there will have been a number of people who did not get a formal diagnosis because their symptoms were so mild.

Both the Tories and the Liberal Democrats backed the move to the new phase but both parties expressed concerns that not all parts of the government's pandemic plan - including the dedicated flu helpline - were in place.

The announcement comes as a survey by London's Institute of Psychiatry finds the public's response to swine flu has been "muted".

A poll of 1,000 adults, published online by the British Medical Journal, found only 24% were anxious about the outbreak with only 2% reporting "high anxiety".

Three quarters said they had not changed the frequency with which they washed their hands, despite this being one of the core messages of the public health campaign.

However the researchers say their findings suggest it is better to keep the public as informed as possible in order to maximise the chance they will make changes to their behaviour.