US declares swine flu 'emergency'

US President Barack Obama has declared swine flu a national emergency.

The White House said the president signed the proclamation concerning the 2009 H1N1 outbreak on Friday evening.

It increases the ability of treatment facilities to handle a surge in H1N1 patients by easing the implementation of emergency plans.

Last week US officials said swine flu activity was widespread in 46 states. More than 1,000 US deaths have been linked to the virus.

Health officials say the infections are already comparable to peak season flu levels.

Vaccine warning

US officials said the president's declaration was similar to ones issued before hurricanes make landfall.

SWINE FLU SYMPTOMS
Human body with internal organs
Typical symptoms: sudden fever (38C or above) and sudden cough
1. Other symptoms include: Tiredness and chills
2. Headache, sore throat, runny nose and sneezing
3. Stomach upset, loss of appetite, diarrhea
4. Aching muscles, limb or joint pain
Source: UK NHS

It allows authorities to bypass certain federal requirements in order to deal more effectively with emergencies.

The aim of the directive is to remove bureaucratic hurdles, allowing sick patients to receive treatment more quickly and giving health-care providers more flexibility in providing it.

Paperwork on patients can be reduced and additional health centres set up outside hospitals to care for the sick.

In his proclamation statement, Mr Obama says the 2009 H1N1 pandemic "continues to evolve".

"The rates of illness continue to rise rapidly within many communities across the nation, and the potential exists for the pandemic to overburden health care resources in some localities."

He said the US had already taken "proactive steps" by implementing public health measures and developing an effective swine flu vaccine.

However, the government has admitted there are delays in the delivery of vaccines.

It had hoped to roll out 120 million doses by mid-October.

It now hopes for about 50 million by mid-November and 150 million in December.

Dr Thomas Frieden, of the US Centers for Disease Control and Prevention (CDC), said on Friday: "We are nowhere near where we thought we'd be by now."

Given the shortfall, New York State on Friday stayed a directive ordering health care staff to be inoculated or risk losing their jobs.

The CDC says widespread influenza activity in 46 states is "unprecedented during seasonal flu".

It said the hospitalisation rates for laboratory-confirmed swine flu were still climbing.

Although figures are hard to verify, it is thought H1N1 has hospitalized about 20,000 people in the US.

Visits to the doctor for influenza-like illnesses were also much higher than expected for the time of year, the CDC said.

The seasonal flu peak is usually between late November and early March.

Children and young adults have been among the hardest hit by H1N1. Almost 100 of the deaths have been children.


Flu viruses mutate over time causing small changes to proteins on their surface called antigens. If the immune system has met a particular strain of the virus before, it is likely to have some immunity; but if the antigens are new to the immune system, it will be weakened.


The influenza A virus can mutate in two different ways; antigenic drift, in which existing antigens are subtly altered, and antigenic shift, in which two or more strains combine. Antigenic drift causes slight flu mutations year on year, from which humans have partial, but not complete, immunity. By contrast, the new strain of H1N1 appears to have originated via antigenic shift in Mexican pigs


The name "swine flu" is a slight misnomer as it is believed pigs acted as a mixing pot for several flu strains, containing genetic material from pigs, birds and humans. Most humans have never been exposed to some of the antigens involved in the new strain of flu, giving it the potential to cause a pandemic.


The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.

Source: http://news.bbc.co.uk/2/hi/americas/8324070.stm

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2009 H1N1 Flu: Situation Update

Key Flu Indicators

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of October 11-17, 2009, a review of the key indictors found that influenza activity continued to increase in the United States from the previous week. Below is a summary of the most recent key indicators:

* Visits to doctors for influenza-like illness (ILI) increased steeply since last week in the United States, and overall, are much higher than what is expected for this time of the year. ILI activity now is higher than what is seen during the peak of many regular flu seasons.

* Total influenza hospitalization rates for laboratory-confirmed flu are climbing and are higher than expected for this time of year.

* The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and has been higher than what is expected at this time of year for two weeks. In addition, 11 flu-related pediatric deaths were reported this week; 9 of these deaths were confirmed 2009 H1N1, and two were influenza A viruses, but were not subtyped. Since April 2009, CDC has received reports of 95 laboratory-confirmed pediatric 2009 H1N1 deaths and another 7 pediatric deaths that were laboratory confirmed as influenza, but where the flu virus subtype was not determined.

* Forty-six states are reporting widespread influenza activity at this time. They are: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. This many reports of widespread activity are unprecedented during seasonal flu.

* Almost all of the influenza viruses identified so far are 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

Center for Disease Control 2009 H1N1 Flu U.S. Situation Update link - http://www.cdc.gov/h1n1flu/updates/us/

Source: http://www.cdc.gov/h1n1flu/update.htm

Swine flu could cause as many as 90,000 US deaths

WASHINGTON (AFP) - Swine flu could infect as much as half of the US population this fall and winter and cause up to 90,000 deaths, President Barack Obama's science advisors warned Monday.

A lab technician working on a swine-flu detection DNA test.
Swine flu could infect as much as half of the US population this fall and winter and cause up to 90,000 deaths, President Barack Obama's science advisors warned Monday.
Laying out a "plausible scenario" for the epidemic's impact in the United States, the report painted a grim picture of stress on the US health care system as it struggles to cope with a flood of flu patients.

The epidemic's resurgence could "produce infection of 30-50 percent of the US population this fall and winter, with symptoms in approximately 20-40 percent of the population (60-120 million people), more than half of whom would seek medical attention," the report said.

As many as 1.8 million people could be admitted to hospitals with up to 300,000 of them requiring treatment in intensive care units.

"Importantly, these very ill patients could occupy 50-100 percent of all ICU beds in affected regions of the country at the peak of the epidemic and could place enormous stress on ICU units, which normally operate close to capacity," it said.

The epidemic, it said, "could cause between 30,000 and 90,000 deaths in the United States, concentrated among children and young adults," it said.

That compares with 30,000 to 40,000 deaths from seasonal flu each year, mainly among people over age 65.

The report said the epidemic poses "especially high risks" for people with pre-existing conditions such as pregnant women and patients with neurological disorders, respiratory impairment, diabetes or severe obesity.

It also mentioned Native Americans as being at risk from the swine flu.

The flu's resurgence could occur as early as September when the school term begins, and peak in mid-October.

But a vaccine against the A(H1N1) virus is only projected to be available in mid-October, and it will take vaccinated individuals several more weeks to develop protective immunity, the report said.

"This potential mismatch in timing could significantly diminish the usefulness of vaccination for mitigating the epidemic and could place many at risk of serious infection," it said.

The report by the President's Council of Advisors on Science and Technology (PCAST) said that while the virus is "unlikely to resemble the deadly flu pandemic of 1918-19," the current strain still "poses a serious health threat."

According to the latest official US figures, the 2009 swine flu strain has already killed 522 people in the United States and hospitalized almost 8,000 people since it emerged in Mexico at the end of April.

The group recommended accelerating preparation of flu vaccines for distribution to high-risk individuals and clarifying guidelines for the use of antiviral medicines.

Advisors also called on the public to stay informed on A(H1N1)'s expected spread as the northern hemisphere's regular flu returns with the colder months.

These efforts involve using social networking sites on the Internet to propagate health messages and an "intensive public education" campaign to promote awareness to the threat.

The White House also needs to create a post that has "primary authority to coordinate key decisions" for fighting the pandemic, the report said.

Among other recommendations are for workplaces to "liberalize rules for absenteeism" so employees are not pressured to come to work when they feel sick.

Overall, the PCAST gave the administration positive reviews for its preparation.

"The Federal Government's response has been truly impressive and we've all been pleased to see the high level of cooperation among the many departments and agencies that are gearing up for the expected fall resurgence of H1N1 flu," said PCAST co-chair Harold Varmus.

"This virus has pulled us all together in common cause," said another PCAST co-chair, Eric Lander. "The preparations are the best ever for an influenza pandemic," he said.

Over 20 pharmaceutical companies around the world are racing to test, produce and distribute more than a billion doses of the vaccines in anticipation of the second wave of infection.

A(H1N1) has created a health crisis in Latin America throughout the southern continent's winter months, causing more than 1,300 deaths, according to an AFP tally of individual government tolls.

Source: http://health.yahoo.com/news/afp/healthfluuswhouse_20090824233142.html;_ylt=AnNMSdyfblExRJPNS_KtpndPj4t4