NOVEL H1N1

[dothedd]

INFLUENZA >> NOVEL H1N1 INFLUENZA (SWINE FLU) >> NEWS 

Ferret study underlines persistent threat of swine flu viruses

Sep 11, 2012 (CIDRAP News) – A Korean-US research team has identified an H1N2 strain of swine influenza capable of killing ferrets and spreading among them by respiratory droplets, underlining the continuing threat of swine flu to humans amid a wave of swine-origin flu cases in Americans exposed to pigs at agricultural fairs.

The researchers exposed groups of ferrets, which are considered the best animal models for human flu, to four swine flu viruses isolated in Korea—two H1N2 and two H3N2. One of the H1N2 isolates caused severe or fatal illness in the animals and spread to other ferrets housed nearby without direct contact, according to the scientists' report in the Proceedings of the National Academy of Sciences.

In addition, when the scientists analyzed the virus in the ferrets that were infected secondarily, they found that it had two mutations and was able to spread even more readily to other ferrets.

The findings come 3 years after another swine-origin flu virus, the 2009 H1N1 strain, triggered a pandemic, which the authors say marked the broadest known spread of a swine-origin strain in humans.

Richard J. Webby, PhD, a co-author of the study, said the newly identified virus, dubbed Sw/1204, is closely related to swine H1N2 viruses in the United States. Experts say the H1N2 subtype is fairly common in swine, and a few swine-origin H1N2 infections, called H1N2v, have been identified in humans in recent years, including four cases in people who were exposed to pigs at the Minnesota State Fair in August.

Another swine-origin virus, variant H3N2, or H3N2v, has infected nearly 300 people in the United States this summer, most of whom showed pigs or were otherwise exposed to pigs at county and state fairs. Sixteen patients were hospitalized, and one person, a woman who had preexisting health problems, died.

Webby, who is with St. Jude Children's Research Hospital in Memphis, said Sw/1204 probably represents only a minor threat to humans, because it is related to the 2009 H1N1 strain, and therefore anyone who was exposed to the latter would have "considerable immunity" to it.

Still, the findings show the continuing pandemic potential of reassortant swine flu viruses, the researchers say.

The authors write that, because swine flu surveillance is "abysmal," it is unclear whether swine flu subtypes other than H1N1 could spread among humans and cause serious illness. Their aim was to assess the zoonotic potential of representative Korean "triple-reassortant" H1N2 and H3N2 viruses that are related to North American strains. "Triple-reassortant" generally refers to flu viruses that contain genes from avian, human, and swine flu strains.

They picked four isolates: two H1N2 viruses collected in 2009 (before the pandemic) and two H3N2 collected identified in 2007. Groups of three ferrets were exposed to high doses of these strains via the nose and throat and then were observed for 14 days.

Three of the strains grew only moderately, were undetectable in upper respiratory samples after a week, and caused no clear signs of disease, according to the report.

But the ferrets dosed with the Sw/1204 (H1N2) virus got very sick starting 3 days after infection, with major weight loss, labored breathing, high fever, and other signs. One of the animals died after 7 days, and the other two were euthanized (at 7 and 10 days) because of their severe illness.

To test transmissibility, the authors placed uninfected ferrets in cages near each of the infected ones, but not close enough for direct contact. Only Sw/1204 spread via respiratory droplets to all three uninfected ferrets. One of these contact ferrets died 12 days after exposure, and another was euthanized because of severe illness.
A comparative molecular analysis revealed that the virus from the contact ferrets, called CT-Sw/1204, had acquired two mutations—one each in its hemagglutinin (HA) and neuraminidase (NA) proteins—that distinguished it from the original or wild-type Sw/1204 virus. Evidence indicated that these mutations, called HA225G and NA315N, evolved mainly during viral replication in the originally inoculated animals.

In further experiments, the researchers inoculated additional groups of ferrets with CT-Sw/1204 and found that it proved lethal a day earlier and spread more quickly to other ferrets (as soon as 1 day after exposure, versus 4 to 5 days) than did the original virus.

In still other experiments, the authors found that the CT-Sw/1204 grew more efficiently than the original Sw/1204 in human respiratory cell cultures. In freshly biopsied lung tissue samples, for example, the original virus showed minimal infectivity, whereas CT-Sw/1204 grew to high titers within 36 hours—a finding consistent with the ferret results.

To examine the effects of the two mutations on viral pathogenicity and transmissibility, the authors also used reverse genetics techniques to generate Sw/1204 viruses with just one of the mutations, and then exposed mice and ferrets to these recombinant strains. The results suggested that both of the changes may have contributed to virulence and transmissibility.

The team also determined that the recombinant strains of Sw/1204, with or without the two mutations, caused only mild illness in pigs and were susceptible to neuraminidase inhibitors used to treat flu.

"Overall, we have presented evidence proposing the role of HA225G and NA315N as potential virulence markers of TRSw [triple-reassortant swine] influenza viruses in mammalian hosts," the report states. "Our findings further support the continuing pandemic potential of TRSw influenza viruses circulating in pigs," thereby showing that surveillance in pigs is "vital and beneficial."

Webby said it is very unusual for a swine flu virus to cause severe illness in ferrets and that swine flu viruses typically don't spread easily among ferrets, either. By comparison, ferret experiments with the 2009 H1N1 virus showed that it generally was not lethal, though it did cause a few cases of severe illness, he told CIDRAP News.

"I'd say the generalization is that the pandemic virus was a bit more able to cause disease in most [animal] models than the average swine virus," he said.

Concerning the potential risk of Sw/1204 to humans, Webby said, "I think this particular one, the threat is fairly minor because it's a not-so-distant cousin of the pandemic virus itself, so anyone who was exposed to the pandemic virus would have considerable immunity to this particular strain."

Using serologic tests (hemagglunination inhibition), Webby and his colleagues found that antibodies to the 2009 H1N1 virus cross-reacted to a considerable degree with Sw/1204, suggesting that previous exposure to 2009 H1N1 or vaccination against it is probably beneficial, their report says. But it cautions that this remains to be confirmed.

Webby said the H1N2 viruses used in the study are "quite closely related" to swine H1N2 strains in the United States. "The viruses in Korea were likely imported from the US," he said. "We've done some risk assessments on some viruses circulating in the US and haven't seen any phenotypes with the properties of this [Sw/1204] virus."

Although the study generated a mutant H1N2 virus that spread more easily among ferrets while maintaining its virulence, Webby said the study did not violate the voluntary moratorium that leading flu researchers announced in January on studies involving the generation of H5N1 avian flu viruses with increased transmissibility in mammals.

The moratorium was declared by 39 leading researchers, including Webby, in response to the controversy over proposed publication of two studies in which scientists generated H5N1 viruses that could spread in ferrets by the aerosol route. Out of concern about the potential for release of a dangerous virus, a US committee of experts initially recommended that full versions of the studies not be published, but the group later reversed itself, and the studies were published in May and June.

Webby noted that the moratorium specifically targeted research on highly pathogenic H5N1 viruses, with no mention of other subtypes. Also, much of the research in the new report was done before the moratorium was launched.

He added, "A critical piece of the moratorium was that we shouldn't stop characterizing viruses that are out there. Essentially this was a characterization of a virus that was isolated from pigs; it wasn't designed to create a more virulent and more transmissible virus.

"There were some mutations that occurred during the analysis of this virus, and they were described in this paper. Certainly no mutations were intentionally introduced that enhanced transmission or pathogenicity."

Webby also commented that swine flu viruses are not on the list of 15 agents and toxins cited in the US government's policy for oversight of "life sciences dual-use agents of concern," which was announced in March. It calls on federal agencies to review the potential risks of federally funded studies involving those agents and toxins.
The research moratorium was originally intended to last just 60 days, but it has been extended indefinitely as scientists await further development of guidelines for the review of dual-use studies.

In the meantime, Webby said, "We're all thinking hard about what experiments we do, the potential implications. The actual review processes that need to be done will be coming down the pipeline."

Pascua PNQ, Song MS, Lee JH, et al. Virulence and transmissibility of H1N2 influenza virus in ferrets imply the continuing threat of triple-reassortant swine viruses. Proc Natl Acad Sci 2012 Sep 10 (early online release) [Abstract]

www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/sep1112ferrets.html

[dothedd]

H1N1v Case In Ontario Canada

Recombinomics Commentary 16:00

September 25, 2012 

Dr. Arlene King says the man is confirmed as having been infected with an H1N1 variant (H1N1v) influenza virus.

King says the man, who is not being identified, is being treated and closely monitored in a hospital in southwestern Ontario.

The above comments describe the first H1N1v case in Canada this year. The genetic relationship between this isolate and the 2012 US isolate, A/Missouri/12/2012, is unclear, as is the presence of an H1N1pdm09 M gene. In the US, the H1N1v isolate from 2011, A/Wisconsin/28/2011, and the above 2012 isolate have an H1N1pdm09 M gene, as did the four H1N2v cases (including A/Minnesota/12/2012, A/Minnesota/13/2012, A/Minnesota/14/2012 which are virtually identical to each other). Similarly, the 306 H3N2v cases in 2012 also had an H1N1pdm09 M gene and all of the 58 public sequences have an N2 gene which matches the novel N2 seen in the sequences linked to the West Virginia day care center in late 2011 (A/West Virginia/06/2011 and A/West Virginia/07/2011). Moreover, all other variants in the US in 2010 and 2011 (6 H3N2v cases in 2011 and 1 H1N2v case in 2011) had a PB1 with E610D, which is present in all H1N1pdm09 sequences. Thus, it is likely that the Ontario isolate also has an H1N1pdm09 M gene or PB1 with E618D.

The Ontario cases creates an unprecedented situation involving three variant sub-clades (in addition to H1N1pdm09) co-circulation in North America. In 2011 the three sub-clade were co-circulating at the end of the year, but there was only one H1N1v and H1N2v case. In 2012 there are currently 306 H3N2v, 4 H1N2v, and 2 H1N1v cases and all US cases have an H1N1pdm09M gene.

Release of the sequences from the Ontario case would be useful.

[Malarky]

Do you care that there is more to the world than potentially fatal diseases?

[dothedd]

• Mauritius airport on high alert after discovery of H1N1 flu case
• Aug 2, 2013

Mauritius on Friday put its international airport on high alert after this week's confirmation of the first case of H1N1 flu.

Unconfirmed reports indicated that two other H1N1 flu cases had been diagnosed after the first hospitalization, while the Indian Ocean island country's Health Ministry said 30 other cases had been reported.

Employees of Mauritius Duty Free Paradise Co. Ltd, where the infected person was working, are very worried after the first hospitalization and accused the authorities of lack of communication.

However, a vast disinfection and clean-up operation was organized on Wednesday.

Elsewhere, the staff at the Intensive Care Unit (ICU) at Candos hospital in the central region of the island are also fearing about their health status, with nurses demanding that necessary measures be taken to protect workers at the hospital.

However, the Health Ministry reiterated that there was no need to panic. A doctor from the ministry said the H1N1 virus is always treated just like any other seasonal flu.

The deputy director for health services, Dr. Nundlall, told the media on Thursday the ministry was monitoring the spread of A H1N1 virus.

He said there were three types of the virus in Mauritius: flu B, Flu A (H3N2) and flu A (H1N1).

Dr. Nundlall recalled that the World Health Organization (WHO) had declared the end of the H1N1 pandemic in 2010, and added that a vaccine to fight the flu had been developed.

He explained that although A (H1N1) was in the category of seasonal flu, the Mauritius citizens can contract it because it is a tropical country.

The Mauritius citizens have been urged to turn out for vaccination through the prevention campaigns that have been initiated by the health ministry.

[dothedd]

Oct 1, 2012 19:19:43 GMT -5 Malarky said:

Do you care that there is more to the world than potentially fatal diseases?

[dothedd]

• Mauritius airport on high alert after discovery of H1N1 flu case

• Aug 2, 2013

Mauritius on Friday put its international airport on high alert after this week's confirmation of the first case of H1N1 flu.

Unconfirmed reports indicated that two other H1N1 flu cases had been diagnosed after the first hospitalization, while the Indian Ocean island country's Health Ministry said 30 other cases had been reported.

Employees of Mauritius Duty Free Paradise Co. Ltd, where the infected person was working, are very worried after the first hospitalization and accused the authorities of lack of communication.

However, a vast disinfection and clean-up operation was organized on Wednesday.

Elsewhere, the staff at the Intensive Care Unit (ICU) at Candos hospital in the central region of the island are also fearing about their health status, with nurses demanding that necessary measures be taken to protect workers at the hospital.

However, the Health Ministry reiterated that there was no need to panic. A doctor from the ministry said the H1N1 virus is always treated just like any other seasonal flu.

The deputy director for health services, Dr. Nundlall, told the media on Thursday the ministry was monitoring the spread of A H1N1 virus.

He said there were three types of the virus in Mauritius: flu B, Flu A (H3N2) and flu A (H1N1).

Dr. Nundlall recalled that the World Health Organization (WHO) had declared the end of the H1N1 pandemic in 2010, and added that a vaccine to fight the flu had been developed.

He explained that although A (H1N1) was in the category of seasonal flu, the Mauritius citizens can contract it because it is a tropical country.

The Mauritius citizens have been urged to turn out for vaccination through the prevention campaigns that have been initiated by the health ministry.

[dothedd]

November 26, 2013

The 2009 H1N1 "swine flu" epidemic killed up to 203,000 people across the globe -- a death toll 10 times greater than initially estimated by the World Health Organization, researchers say.

In a study published Tuesday in the journal Plos Medicine, epidemiologists used data on respiratory deaths in 20 nations to calculate a global mortality rate for the pandemic.

Prior to this research, the WHO counted just 18,631 lab-confirmed cases of H1N1, a viral infection of the airways.

"This study confirms that the H1N1 virus killed many more people globally than originally believed," read a statement from Lone Simonsen, a research professor in the Department of Global Health at George Washington University.

This study calls into question the true numbers for H5N1, H7N9 & MERS. Lab cases apparently are just the tip of the iceberg.

[Deleted]

"So they went along, and they went along, and they went along, till they met Turkey-lurkey. 'Where are you going, Henny-penny, Cocky-locky, Ducky-daddles, and Gooseypoosey?' says Turkey-turkey. 'Oh! we're going to tell the king the sky's a-falling,' said Henny-penny, Cocky-locky, Duckydaddies, and Goosey-poosey. 'May I come with you, Hennypenny, Cocky-locky, Ducky-daddles, and Goosey-poosey?' said Turkey-lurkey. 'Oh, certainly, Turkey-turkey,' said Henny-penny, Cocky-locky, Ducky-daddles, and Gooseypoosey. So Henny-penny, Cocky-locky, Ducky-daddles, Goosey-poosey, and Turkey-lurkey all went to tell the king the sky was a-falling..."

www.sacred-texts.com/neu/eng/eft/eft21.htm

 I could see how "Avian influenza" could cause the company considerable anxiety.

[dothedd]

H1N1pdm09 Louisiana Tamiflu Resistance Cluster
Recombinomics Commentary 21:45
November 19, 2013

The CDC has released a series of H1N1pdm09 sequences from the current season, which included two sets of sequences from Louisiana, which had H274Y, signaling Tamiflu (oseltamivir) resistance. A sample from one case (25F), A/Louisiana/07/2013, was collected on October 7, which was followed by another case (56F), A/Louisiana/08/2013, which was collected on October 9. The relationship between these two cases is unknown, but the virtual identity for all 8 gene segments indicates this sub-clade is spreading via clonal expansion.

In the week 43 FluView, the CDC reported testing on 28 H1N1pdm09 during the 2013/2014 and none were Tamiflu resistant. However, in week 44 nine additional samples were tested, and two were resistant, strongly suggesting that the two examples were the two cases described above. In week 45 the CDC reported one more case of resistance, but those sequences have not been released, so the relationship to the above two cases is unknown.

The sequence similarity between the first two cases signals evolutionary fitness for this sub-clade. More information on the status and relationship of these two cases to each other and the third case, reported in week 45, would be useful.

[dothedd]

H1N1 is Back in Canada... Public Health Professionals Reports a Rise in Flu Cases
12/22/2013

"Cities in Ontario and Alberta have reported clusters of severe cases of influenza, some of the cases have been severe enough that patients have to be admitted to the hospital. H1N1 or swine flu first appeared in Canada in 2009. Misericordia Hospital in Edmonton has reported that nearly a dozen of patients and staff have contracted severe cases of the flu and other clusters have been stated in Windsor and London, Ont., and in Calgary.

Dr. Judy MacDonald of Alberta Health Services says that some influenza patients are now in intensive care. Since September, In Alberta, 68 patients have been hospitalized and three flu-related deaths have also been recorded. Infectious disease specialist Dr. Neil Rau says," We are seeing a large number of cases of new outbreaks in populations we thought were already protected, and that to me is kind of a surprise".

Testing in British Columbia propose that merely 50% of adults, 35% of young adults and only 20% of children who are less than 5 years of age are immune to H1N1. Dr. Danuta Skowronski of the B. C. Centre for Disease Control said tests also signify that `the virus is starting to evolve'.

The National Respiratory and Enteric Virus Surveillance System and the U. S. World Health Organization tested 7,294 specimens from all over the world for the week of December 8-14, 2013."

[dothedd]

I'M ON VACATION AND WON'T BE POSTING UNTIL AFTER THE FIRST OF THE YEAR!  However, please feel free to post related thread information. 

[dothedd]

Official: 6 swine flu deaths in Hidalgo County this season

Daniella Diaz | The Monitor | Posted: Thursday, January 2, 2014 9:50 pm
EDINBURG — Since Thanksgiving, six people in Hidalgo County have died from the H1N1 influenza strain — commonly known as swine flu, county health officials said.
Including the six people, there have been a total of 24 confirmed cases of swine flu in the county this flu season, said Eddie Olivarez, who heads the Hidalgo County Health and Human Services Department.

County officials hosted a news conference Thursday morning in at Hidalgo County Judge Ramon Garcia’s office to update Rio Grande Valley media. 

The youngest person who died as a result of the H1N1 strain was 7 years old, Olivarez said. The others included one person in the 20s, two in their 30s and two in their 50s. He said he did not have further information about the victims, including their gender or prior condition.
Everyone who has died from the H1N1 strain suffered from previous health conditions such as
morbid obesity, hypertension and diabetes, Olivarez said.

But Olivarez said with only 24 confirmed cases, people shouldn’t worry because the H1N1 flu strain has not reached the status anywhere near of an epidemic. That pales in comparison with the 2009 swine flu epidemic that swept Hidalgo County and much of the country.
During that outbreak, thousands of people contracted swine flu, leaving 27 dead in Hidalgo County alone.

When asked why the death rate compared with confirmed H1N1 cases is far higher than in 2009, Olivarez said it's because his office does not have the total number of swine flu cases in Hidalgo County.

"We're in a very different situation than we were in 2009," Olivarez said in an interview. "Back then, we didn't know what H1N1 was or how to prevent it and the whole world was watching the numbers closely. Now we have the vaccine as a preventative measure and it's not required to be reported."

County health officials have been conducting “active informal surveillance” on the cases of H1N1 because influenza is not a reportable condition in Texas, nor are adult mortalities, Olivarez said. Only child mortalities are required to be reported to the department, said county spokeswoman Karina Cardoza.

[dothedd]

Alberta flu cases spike, 5 deaths confirmed

CBCCBC – Thu, 2 Jan, 2014

Alberta Health Services (AHS) says there are more than 965 confirmed flu cases in the province and there have been five deaths.

"Those are only people who have gone to seek medical attention and physicians have done specimens that have been sent to the lab and those have been confirmed positive," said Dr. Judy McDonald. "We expect that there is much more influenza circulating in our communities that has not been lab confirmed."

Officials say 920 of those cases are of the H1N1 strain, which is covered by this year's flu vaccine. The overall number of flu cases has jumped by 50 per cent in one week.
Dr. Glen Armstrong, an infectious disease expert, says the numbers aren't a record but more than the province has seen in recent years.
"It may be that because we've had a bit of a holiday over the last couple of years. People have become complacent and are thinking, 'OK, it's no big deal, you know I don't need to get vaccinated,'" he said.

Armstrong says even if you got the H1N1 vaccine during the 2009 pandemic, you should get immunized again.

"Because you don't get lifelong immunity,... you get sort of a spike of immunity that will protect you for maybe a year or so. But after that immunity starts to wane and so this is a good opportunity to get revaccinated and to boost your immunity back up again to give you maximum protection," he said.
Health officials are urging people to get the vaccination, particularly before children head back to school.

Albertans who have not yet received a flu shot can still visit AHS mass immunization clinics, local pharmacies and family physician offices.

The vaccine is still available, free of charge, to all Albertans six months of age and older. But officials are reminding Albertans that children under the age of nine are not able to receive the vaccine at pharmacies.

Alberta Health Services clinics at Brentwood Mall in Calgary's northwest and at the South Calgary Health Centre are both open today.

Mass immunization clinics in Edmonton will reopen Friday at the Bonnie Doon Health Centre and Northgate Health Centre from 9 a.m. to 4:30 p.m. MT.
For complete details on clinic locations and hours, call Health Link Alberta toll free at 1-866-408-5465 or visit albertahealthservices.ca/influenza.

[dothedd]

QUOTES:

What happens when H1N1 hits China, if it hasn't already? YIKES!

From the CDC: "During 2009, a total of 10,844 laboratory-confirmed cases of pandemic (H1N1) 2009 were reported in Beijing, People’s Republic of China. However, because most cases were not confirmed through laboratory testing, the true number is unknown. Using a multiplier model, we estimated that ≈1.46–2.30 million pandemic (H1N1) 2009 infections occurred." H1N1 was a HUGE problem in China.

Swine Flu (H1N1) + Bird Flu (H7N9 &/or H5N1) = Pandemic

Note: There is absolutely nothing in the Chinese news about H1N1. It either hasn't hit China yet, or they are keeping a very tight lid on things...

January 2014

We now know H1N1 is back with a vengeance in Canada, New York, Texas, Alabama, Europe, Alaska, Florida, St. Louis, South Dakota, etc...

ABC news just showed Flu spreading across nation...

H1N1 is putting people of all ages on life support per this report tonight.

H1N1 is hospitalizing people with report focusing on Michigan on NBC evening news.

[dothedd]

Seasonal flu widespread in the United States: CDC

Jan. 03, 2014 4:14PM PST

NEW YORK (Reuters) - Nearly half of the United States is reporting widespread influenza activity, most of it attributed to the H1N1 virus that caused a worldwide pandemic in 2009, the U.S. Centers for Disease Control and Prevention said on Friday.

Thousands of people die every year from flu, which peaks in the United States between October and March. The flu is spreading quickly this season, with 25 states already reporting cases, the CDC said.

"We are seeing a big uptick in disease in the past couple of weeks. The virus is all around the United States right now," said Dr. Joe Bresee, chief of Epidemiology and Prevention in the CDC's Influenza Division.

In 2009-2010, the H1N1 virus, also known as swine flu, spread from Central Mexico to 74 other countries, killing an estimated 284,000 people, according to the CDC.

While younger people were more susceptible to H1N1 in 2009, Bresee said it is too early to tell whether the same will be true this year.

This season's virus has killed six children in the United States, according to CDC data. The agency does not track adult deaths, but dozens have been reported around the country.

"There is still a lot of season to come. If folks haven't been vaccinated, we recommend they do it now," Bresee said.

Texas has been one of the harder hits states, where at least 25 people have died this season from the flu, local health officials said.

The Texas Department of State Health Services issued an "influenza health alert" on December 20, advising clinicians to consider antiviral treatment, even if an initial rapid-flu test comes back negative. Texas health officials also encouraged people to get a flu vaccination.

"The flu is considered widespread in Texas," Carrie Williams, a spokeswoman for the state's health department, said.

[dothedd]

MEDICINE NET

www.medicinenet.com/foods_to_eat_during_flu_pictures_slideshow/article.htm

Popsicles
An icy popsicle can soothe a sore, prickly, swollen, or dry throat. It can also help keep you hydrated, which is key when battling the flu. Getting enough fluids can keep mucus thin and help lessen congestion. Look for popsicles made from 100% fruit juice to make sure you're getting vital nutrients and not sugar water. Some flavors to try: apple, grape, or strawberry.

Turkey Sandwich
Turkey is a good, lean protein, essential to solid nutrition. And although you may not feel like it, eating can help give your body energy to fight illness. Try adding cranberry sauce for a spike of flavor and comfort-food taste.

Vegetable Juice
Making and eating a salad is probably one of the last things you'll feel up to while recovering from the flu. Down a glass of low-sodium vegetable juice instead. You'll load up on immune-boosting antioxidants and keep yourself hydrated. Craving a sweet taste? Go with 100% fruit juice.

Chicken Soup
Nourishing and hydrating, there's also some scientific evidence that chicken soup may help with healing and have mild anti-inflammatory effects. Studies have found that hot chicken soup can improve the ability of cilia, the tiny hair-like parts of the nasal passages, to protect the body from bacteria and viruses.

Garlic
If you feel up to it, garlic can be a good choice to spice up foods like soup. It appears to have antimicrobial and immune-stimulating properties and may give you slight relief from congestion.

Ginger
Stomachache? Nausea? Ginger is a home remedy often used to soothe these symptoms. Some studies suggest it may help fight inflammation. Try adding it freshly grated or in powdered form to other foods, or drinking flat ginger ale.

Hot Tea
Green, oolong, and black tea offer disease-fighting antioxidants. And breathing in the steam can help relieve congestion. Add a spoonful of honey and a squeeze of lemon to help soothe a sore throat. If caffeine bothers you, opt for decaf or herbal versions.

Banana
Sliced, mashed, or whole, bananas are easy on the stomach. They can be a go-to food if you've been hit with symptoms like nausea, vomiting, and diarrhea, which often occur in kids with the flu. Bananas, along with rice, applesauce, and toast, make up the BRAT diet -- often the first foods doctors encourage people to try when they're recovering from stomach flu and ready for solid foods.

Toast
Although it brings up the rear of the BRAT diet, toast is nothing to ignore. If you can manage food, try toast or crackers. They can be convenient foods when you're fighting illness. Plus, they pair well with chicken noodle soup and their satisfying crunch can take the edge off hunger when your stomach can't handle much.

Meal Replacement Drinks
If your appetite has returned, try one of these to make sure you're getting proper nutrients and calories. Look for lactose-free drinks with at least 6 grams of protein and that are low in sugar. Flavors like strawberry and chocolate may make getting essential vitamins, nutrients, and calories more attractive.

[dothedd]

TEXAS: 

Dallas County Severe H1N1 Cases Spike Higher

Recombinomics Commentary 23:45

January 15, 2014

During weeks 52-1, 70 new ICU admissions were reported, including 30 ventilated patients, 27 BiPAP patients, and 2 patients on ECMO.

During weeks 51-52, 60 new ICU admissions were reported, including 24 ventilated patients, 24 BiPAP patients, and 1 patient on ECMO.

The above comments from the Dallas County week 1 report (in red) and week 52 report (in blue) describe the dramatic rise in serious influenza cases. Texas prepared a special report on pH1N1 cases during the 2009/2010 season, which included a breakdown by county. For that entire season, Dallas County reported 56 ICU cases. This marked increase in cases in Dallas County is similar to the spike in hospitalized cases reported in California, which tracks P&I hospitalizations. The data in the California report also showed numbers that topped the 2009/2010 season, as well as 2012/2013, which was dominated H3N2, which targeted the elderly.

These numbers, at a relative early point in the flu season, raise concerns that the current pH1N1 in circulation has acquired polymorphisms which target the human lung, such as L194I, D225G, and Q226R. Recently released sequences by the CDC demonstrated the presence of these changes in almost all egg isolates, as expected since human lung and chicken eggs have high levels of gal 2,3 receptors, for which affinity is increased by the genetic changes cited above.

Moreover, the Chinese National Influenza Center release a series of H1N1 sequences from fall 2013 collections, which include a high frequency of egg isolates, which were also dominated by the above genetic changes, as well as additional changes including S193R and S193I raising concerns that these changes targeting lung were on the rise and on the same genetic background as the sequences found in the United States.

The China data suggests that release of more sequences from egg isolates from US cases would be useful.

[dothedd]

Read the Stories

These first-person and family accounts provide an intimate, personal view of the 1918 and 1957 pandemics that goes beyond the staggering statistics associated with those events.

www.flu.gov/pandemic/history/storybook/stories/index.html  

[dothedd]

Flu spreading rapidly in Japan, up 40% since last week...

Source: NHK, 2/7/14

"The number of influenza patients is rising rapidly in Japan.

The National Institute of Infectious Diseases says its survey of 5,000 medical institutions throughout the country found that about 170,000 flu patients visited hospitals or clinics during the week ending last Sunday.

Based on this research, the institute says an estimated 1.8 million people visited medical institutions. That's 40 percent more than the previous week.

The number of influenza patients is most rapidly increasing in 40 out of the 47 prefectures, including Tokyo and Osaka.

The institute says about 50 percent of the patients were infected with H1N1 virus during the 5 weeks up to last Sunday. H1N1 spread 5 years ago as a new type of virus.

A medical expert says there is a possibility the disease is spreading mainly among those who were not infected with H1N1 virus during the flu pandemic five years ago."

Again... You won't find one single article out of China regarding the seasonal flu numbers in China.

If the flu problem is this bad in Japan, imagine how bad it must be in China. Then consider we have H7N9, H10N8 & H5N1 in the mix... Not good.

[dothedd]

India threatens to close pharmacies that fail to stock adequate Tamiflu 

February 18, 2015 

SINGAPORE--India health authorities have threatened to close pharmacies in the country that fail to maintain an adequate supply of Tamiflu (oseltamivir) or its generics to treat an outbreak of H1N1 influenza that has claimed at least 624 lives this year.

As the Drug Controller General of India (DCGI) issued the warning, some experts predicted that the recent outbreak was probably on the wane and would be over in less than two weeks as the weather changes. "Swine flu" is known to thrive in cold weather, and India's weather has been warming as spring approaches.

The DCGI issued its supply warning to the All-India Chemists and Druggists Association, saying its members could lose their licenses or face suspension. At the same time, the agency was ordered by another health agency to issue 10,000 more licenses so more pharmacists could supply the drug. Only 2,500 were licensed to sell the drug at the start of the outbreak at the first of the year.

[dothedd]

Swine flu vaccine makers wary about ramping up production 

Companies say stocks of the vaccine available to treat emergency situations 

Sohini Das | Ahmedabad January 25, 2015 Last Updated at 21:10 IST

51 yr old woman dies of swine flu in Delhi

With cases of swine flu on the rise in the recent one and a half months across the country, vaccine makers are on a wait-and-watch mode before they scale up production of their epidemic flu vaccines.

Pharma majors like Ahmedabad-based Zydus Cadila, Delhi-based Panacea Biotech, Hyderabad-based Bharat Biotech, and Pune-based Serum Institute of India, have variants of the epidemic flu vaccine in their kitty. According to Pankaj Patel, chairman and managing director of Zydus Cadila, one of the first companies in India to launch swine flu vaccine VaxiFlu-S in 2010, said that the company always maintained a buffer stock for emergency situations, and can also scale up production as and when required. "We can ramp up production of the vaccine and meet demand within a month's time, if needed," he said.

Cases of swine flu have been recently reported from parts of Gujarat (where the death toll is reportedly around 15 now with over 112 cases), near Hyderabad (over 173 cases reported), and also in and around Delhi (over 100 cases). When contacted, officials from the Union Health Ministry informed that the government has enough stock of the medicine Oseltamivir, which is administered to swine flu patients, and is also working to procure more drugs. SCL Das, secretary, health and family welfare, government of New Delhi, said that there is a definite process to procure drugs or even vaccines in public health system. "As for medicines, we have sufficient stocks," he added.

A senior official in Zydus Cadila, who did not wish to be named, said that, so far there has not been any major tendering by the Union or the state governments to procure the vaccines. He added that vaccines are used mainly as a preventive measure, while Oseltamivir (which Zydus Cadila also manufactures), is given to patients who are already diagnosed with swine flu symptoms.

Rajesh Jain, joint managing director, Panacea Bitoech too informed that so far there has been no major news from any government agency to procure the vaccine.

It may be noted here that vaccine makers had actually reported meagre sales during the last few years, after the demand had picked up significantly during the 2009-2010 break, when over 45,000 cases were reported across the country in those two years. Thereafter, hardly a few hundred cases have been reported every year, impacting the demand for the vaccines.

For that matter, Serum Institute had had to destroy over two million doses of the vaccine in 2011, after there was no demand from the market.

A senior official of a vaccine manufacturer, who did not wish to be identified said that during 2010 and 2011, companies had produced a few million doses of the vaccines, anticipating that people would opt for it as a preventive measure, and also government agencies would stock vaccines for healthcare professionals and paramedics. "Most of the stocks had to be destroyed, and ever since, we have become very cautious about producing in large volumes," he added.

Another dimension is that every year, the US Centers for Disease Control & Prevention (US CDC), issues details about the latest strain of the flu virus which is causing infections that season.

"This comes out around March every year, and post that companies start producing the vaccines for that season. It is not just H1N1 (or swine flu) that causes deaths. There are different kinds of flu viruses, of which, some are deadly," Jain explained.

For example, according to recent media reports, flu has claimed around 56 lives in the US since September last year, and that the H3N2 strain of the virus (seasonal flu) has mutated and therefore the current vaccine doesn't protect against it.

Currently, in India a trivalent vaccine is available, which is claimed to be effective against three strains of the flu virus. Companies like Zydus Cadila and Panacea Biotech had invested significant amounts to develop the indigenous vaccines.

Zydus has spent Rs 80 crore to develop the vaccine in-house together with investing around Rs 50 crore to expand its Moraiya facility that manufactures VaxiFlu.

The company can produce 12 million doses of the vaccine if required. Serum Institute too has invested close to Rs 50 crore to expand its Pune facility that is now equipped to produce around 50 million doses of the vaccine Nasovac annually.

Panacea has invested close to Rs 100 crore to set up a 45 million dose per annum facility at Lalru in Punjab for the Pandyflu vaccine.

As a Mumbai-based analyst pointed out that making of these vaccines would be a difficult task.

"It is indeed a lucrative line of business as well, as the volumes are extremely high, while margins are low. However, most of these companies wait for government tendering to secure the volumes," the analyst added.
www.business-standard.com/article/companies/swine-flu-vaccine-makers-wary-about-ramping-up-production-115012500698_1.html

[dothedd]

Indian City Bans Public Gatherings Over Swine Flu Fears 

AHMEDABAD, India — Feb 25, 2015, 2:04 PM ET

A passenger from India's Gujarat state arrives at the New Delhi railway station wearing a mask as a safe guard from Swine flu, in New Delhi, India, Wednesday, Feb. 25, 2015. Health officials in India are struggling to contain an outbreak of a flu that has claimed more than 700 lives since mid-December. (AP Photo/Bernat Armangue)

A west Indian city has banned most public gatherings in an attempt to halt the spread of swine flu, which has claimed at least 926 lives nationwide in 11 weeks.

Officials prohibited gatherings of five or more people in Ahmedabad, the capital of Gujarat state, starting Wednesday. Marriages and funerals are exempt from the ban, but participants will need to wear protective masks, officials said.

The law invoked for the ban is generally used to maintain law and order, not health, and officials said they would be flexible in interpreting which public events would be prohibited.

Gujarat has had the second-highest number of deaths, with 231, after the northwestern state of Rajasthan, where 234 have died.

Among the thousands in Gujarat testing positive for H1N1, the virus which causes swine flu, were its assembly speaker and state health minister.

Doctors said the death toll was high because many patients delayed going to hospitals.

The Health Ministry said most of the more than 16,000 cases reported nationwide since mid-December were in the states of Gujarat, Rajasthan, Maharashtra, Telangana and Madhya Pradesh.

Federal Health Minister J.P. Nadda urged people not to panic, saying there was enough medicine to cope with the rising number of cases.

The ministry has instructed states to set up isolation wards and is providing free flu tests at some government hospitals.

[dothedd]

25 February 2015 Last updated at 16:47 ET

Swine flu: India health minister urges calm 

In Indian security guard keeps vigil at a swine flu (H1N1) isolation ward of the Ahmedabad Civil Hospital in Ahmedabad on February 3, 2015. 

The outbreak is India's deadliest since 2010 

India swine flu outbreak 'kills 75' 

Hospitals 'working round-the-clock' Watch 

Swine flu infected 'fifth of people' 

Indian Health Minister JP Nadda has urged the public not to panic, as the number of deaths so far this year from swine flu passed 900 from 16,000 cases. 

Rajasthan and Gujarat are among the worst affected states. 

Officials in Ahmedabad, Gujarat's largest city, have announced restrictions on public gatherings as a precautionary measure. 

The current outbreak, which began in December last year, is India's deadliest since 2010. 

Nearly 4,000 people have been killed in separate outbreaks of the H1N1 virus since 2009. 

In Ahmedabad, officials have said weddings and funerals may take place but participants must wear protective masks. 

Jump media playerMedia player helpOut of media player. Press enter to return or tab to continue. 

Sanjoy Majumder reports from Delhi: "With the rising numbers, there is an element of panic" 

The Gujarat state assembly's speaker and health minister both have swine flu. Some opposition politicians have criticised the government's response, describing it as a public health crisis. 

Workplaces and schools have been open as normal but a charity walk and concert are among several public events in Ahmedabad which have been put on hold. 

Organiser Kaushal Mehta said the walk was to have taken place on 1 March: "Around 5,000 [were to] walk for charity. 

"However, due to swine flu and the prohibitionary order we have postponed the event. The experts have told us to wait." 

Doctors believe that as temperatures rise during the summer the effect of the virus will subside. 

[dothedd]

What is swine flu? 

A respiratory disease caused by a strain of the influenza type A virus known as H1N1, which first appeared in Mexico in 2009...

Originated in pigs, but is now a human disease spread by coughing and sneezing
Symptoms similar to those produced by standard, seasonal flu - fever, cough, sore throat, body aches and chills...

Vulnerable groups include pregnant women, children under five, the over-65s and those with serious medical conditions...

[dothedd]

28 January 2015 Last updated at 02:51 ET Share this pagePrint 

India swine flu outbreak 'kills 75'

An outbreak of swine flu in India has killed at least 75 people in just over six weeks, officials say.

Health officials said most of the deaths have been reported from the southern state of Telangana and Rajasthan state in the north.

Experts investigating the cause of the outbreak say low winter temperatures are to blame.

The H1N1 virus, which causes swine flu, first appeared in Mexico in 2009 and rapidly spread around the world.

The virus killed 981 Indians in 2009, 1,763 in 2010, 75 in 2011, 405 in 2012 and 692 in 2013.

It is thought the virus has killed 200,000 people around the world.

Indian officials say swine flu has killed 50 people in Telangana and Rajasthan. Fifteen deaths have been reported from Gujarat. The capital, Delhi, has reported five deaths so far, while neighbouring Haryana reported seven deaths.

Hospitals in affected states have set up isolation wards to treat patients.

Rajendra Rathore, health minister of Rajasthan, where 25 people have died and nearly 100 cases had been recorded, said he was "worried" about the sudden spike in winter.

Health official KC Meena told reporters that experts were investigating whether the virus had undergone a "minor mutation" in the state, although the patients were responding well to medicines.

'Severe winter'
In Telangana, experts said there was no reason to panic, despite 25 people dying since December.

"The number of cases this year is slightly more than the last. One of the reasons could be that the traditionally tropical state has experienced its coldest winter in two decades with temperatures dipping to single digits," L Narendranath, chief of the state-run Nizam's Institute of Medical Sciences told the BBC.

An Indian woman and a child cover themselves with protective masks after the news of the outbreak of swine flu virus as they walk inside the premises of Gandhi Hospital in Hyderabad, India, Wednesday, Jan. 21, 2015.

People are using protective masks to ward off the flu in Telangana
Samples tested at the hospital showed that a third of the "highly suspicious" cases had been found positive for swine flu.

"This year's cases appear to be sporadic and had not affected families and neighbours and communities around them. This could mean that the virus was dormant in the patient, and the relatively cold weather made it virulent," Mr Narendranath said.

Doctors said there was enough stocks of flu medicine available with the government.

Dr MS Chadha, deputy director of India's National Institute of Virology, told the BBC that the spike in cases across India was "not really unusual" as it appeared to be seasonal in nature.

"The virus does not go away easily. So we need to be careful," she said.

What is swine flu? 

Swine flu is a respiratory disease caused by a strain of the influenza type A virus known as H1N1.

The disease originated in pigs, but is now a wholly human disease and is spread by coughing and sneezing.

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu - fever, cough, sore throat, body aches and chills. Some people with the virus also experience nausea and diarrhoea.

Vulnerable groups include pregnant women, children under five, the over-65s and those with serious conditions such as heart disease, asthma, diabetes or immunosuppressive illnesses.

[dothedd]

An Indian security guard keeps vigil at a swine flu (H1N1) isolation ward of the Ahmedabad Civil Hospital in Ahmedabad on February 3, 2015. 

The outbreak is India's deadliest since 2010

Indian Health Minister JP Nadda has urged the public not to panic, as the number of deaths so far this year from swine flu passed 900 from 16,000 cases. 

Rajasthan and Gujarat are among the worst affected states. 

Officials in Ahmedabad, Gujarat's largest city, have announced restrictions on public gatherings as a precautionary measure. 

The current outbreak, which began in December last year, is India's deadliest since 2010.

[dothedd]

India swine flu outbreak spreads across country
21 February 2015 Last updated at 18:32 GMT

Health officials in India are struggling to contain an outbreak of swine flu after the number of cases doubled within a week.

More than 11,000 people have the disease, which has killed more than 700 people since mid-December.

It is the same H1N1 strain that spread rapidly around the world six years ago.

VIDEO: www.bbc.com/news/world-asia-india-31569472

[dothedd]

Serum Institute and Bharat Biotech race to get swine flu vaccines back on the market 

By Amirah Al Idrus 

 February 2015

Swine flu is making a comeback in India, and with a vengeance. After destroying their existing stocks due to poor demand and short shelf life, two local companies will be racing to get their swine flu vaccines back on the market.

Since January, 11,000 people have tested positive for swine flu in India, and 750 of them have died, Al Jazeera reports. Bharat Biotech is working on producing its vaccine, HNVAC, in bulk, and Serum Institute started production of its H1N1 vaccine, Nasovac, in January, according to The Hindu. Nasovac will be commercially available in India by the end of March. The company does not plan to export the vaccine.

Nasovac, an egg-based, live attenuated vaccine, is trivalent, also protecting against H3N2 and Type B influenza. The 65,000-dose batch will be completed in mid-March, according to The Hindu, and will hit the market as soon as the Central Drugs Laboratory in Kasauli, Himachal Pradesh, releases it after testing. A single dose will cost 800 rupees ($12.87).

According to The Indian Express, 180,000 vials of Nasovac were available in December, but there was no demand. The company recently destroyed this stock, which has a shelf life of one year. It is produced using an H1N1 virus strain that is recommended by the WHO.

Serum Institute of India Executive Director Suresh Jadhav
"(Nasovac) can be used during the 2015 winter provided the strain that circulates then remains the same," Dr. Suresh Jadhav, Serum's executive director, told The Hindu.

Serum is also busy working its way into the international vaccine arena, where Big Pharma dominates. The company is working on low-cost vaccines, including those for measles, pertussis and HPV. It is also reportedly in early merger talks with fellow Indian company Cipla, with which it already has an agreement to distribute its vaccines in Europe.

Meanwhile, Bharat Biotech is working on a new-and-improved swine flu vaccine to prevent future outbreaks.

"We have collected samples of virus strains from swine flu patients and Hyderabad and work on sequencing is underway to understand virus genotypes," company chairman Krishna Ella told Live Mint.